Abstract
Background
Rotator cuff tears are associated with significant morbidity. Ultrasound scanning in the diagnosis and evaluation of cuff tears has been shown to be highly sensitive and specific. However, it is hypothesized that ultrasound may not be such a precise modality in the setting of a district general hospital.
Materials and Methods
The present study identified all patients in a 1-year period who underwent shoulder arthroscopy and who had also undergone a preceding ultrasound scan. Tables (2 × 2) were drawn up to compare findings and calculate sensitivity, specificity and predictive values.
Results
Eighty-five patients were identified with a total of 59 (69%) cuff tears detected at surgery. Overall, the sensitivity and specificity of ultrasound was 66% and 54%, respectively. This equated to an overall accuracy of 62%. The positive predictive value was 76% and the negative predictive value was 41%.
Discussion
The results obtained in the present study demonstrate disappointingly low sensitivity, specificity, positive and negative predictive values, as well as accuracy, for the use of ultrasound scanning in the assessment of the rotator cuff. This has implications not only for the diagnostic process, but also in terms of theatre time logistics. It is suggested that a regular multidisciplinary team meeting is held to discuss imaging and consideration of magnetic resonance imaging as an alternative modality in this setting.
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