DIAGNOSTIC EFFICACY OF HIGH-RESOLUTION ULTRASOUND IN CLINICALLY SUSPECTED PATIENTS OF ROTATOR CUFF TEAR AND ITS CORRELATION WITH MAGNETIC RESONANCE IMAGING

Abstract

Background: Rotator cuff tears (RCTs) are among the most common causes of shoulder pain and disability, particularly in middle-aged and elderly individuals. Accurate diagnosis is essential for appropriate management and prevention of long-term functional impairment. Magnetic resonance imaging (MRI) is considered the reference standard for non-invasive evaluation of rotator cuff pathology; however, high-resolution ultrasonography (USG) offers a cost-effective, readily available, and dynamic alternative. This study aimed to evaluate the diagnostic efficacy of high-resolution USG in clinically suspected patients with rotator cuff tears and correlate its findings with MRI.

Materials and Methods: This hospital-based cross-sectional observational study was conducted in the Department of Radio-diagnosis, Geetanjali Medical College & Hospital, Udaipur, over a period of 18 months. A total of 58 adult patients with clinically suspected rotator cuff tears were enrolled using consecutive sampling. All participants underwent both high-resolution ultrasonography and 3-Tesla MRI of the affected shoulder. MRI was used as the reference standard. Diagnostic performance of USG was assessed by calculating sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), diagnostic accuracy, and Cohen’s kappa coefficient.

Results: The mean age of the study population was 53.4 ± 13.6 years, with a male predominance (63.8%). The supraspinatus tendon was the most commonly affected tendon on both USG (79.3%) and MRI (84.5%). Partial-thickness tears were the most frequent pathology identified on MRI (48.3%), followed by full-thickness tears (24.1%). Using MRI as the reference standard, USG demonstrated an overall sensitivity of 90.5%, specificity of 93.8%, PPV of 97.4%, NPV of 78.9%, and diagnostic accuracy of 91.4%, with excellent agreement (κ = 0.80). For full-thickness tears, USG achieved sensitivity, specificity, and accuracy of 92.9%, 97.7%, and 96.6%, respectively (κ = 0.91). For partial-thickness tears, sensitivity, specificity, and accuracy were 82.1%, 90.0%, and 86.2%, respectively (κ = 0.72). MRI was superior in detecting muscle atrophy, fatty infiltration, joint effusion, and labral pathology.

Conclusion: MulHigh-resolution ultrasonography demonstrated excellent diagnostic accuracy and strong agreement with MRI in the detection of rotator cuff tears, particularly full-thickness tears. Given its accessibility, lower cost, and ability to provide dynamic real-time assessment, USG can be considered an effective first-line imaging modality for patients with suspected rotator cuff pathology, while MRI remains valuable for equivocal cases, preoperative planning, and evaluation of associated intra-articular abnormalities.