[Evaluation with ultrasound and arthro-ultrasonography of complete rotator cuff rupture]

Abstract

Introduction: Shoulder ultrasonography is revised in the evaluation of complete rotator cuff tears. Also another technique known as artro-ultrasonography, which consist of a 10 mL solution injection inside the articular capsule to observe its escape to the subacromial-subdeltoidea bursae which implicates rotator cuff tear. It is compared against multiple standards like surgery, magnetic resonance, arthrography and rehabilitation to include positive and negative cases.

Material and methods: 181 consecutive cases were studied with ultrasonography, 27 with artro-ultrasonography. The criteria for tear is the absence of the hyper-ecogenicity in the tendon, hypo-ecogenic gaps inside the rotator cuff and distention of the bursae due to the presence of liquid.

Results: 69% sensibility and 71% specificity for ultrasonography. 92% sensibility and specificity for artro-ultrasonography. The area under the COR curve is 70% for ultrasonography and 93% for artro-ultrasonography. The artro-ultrasonography modified the diagnosis in nine cases, the majority from normal to tear. Three Radiologists proved the agreement with good results.

Discussion: The study contributes to evaluate the performance of ultrasound against multiple standards to correct the great variability in results observed in literature. The contribution of artro-ultrasonography to diagnosis is evaluated. It can be useful in places where accuracy is important and more sophisticated methods like magnetic resonance are not available.