PREVALENCE AND CHARACTERIZATION OF ROTATOR CUFF TEAR IN PATIENTS HAVING FROZEN SHOULDER BY ULTRASOUND AND MAGNETIC RESONANCE IMAGING

Abstract

Background: Clinical examinationof shoulder alone does not provide all diagnostic information required for treatment. Evaluation of patient with shoulder pain often involves assessment of the rotator cuff with a diagnostic test such as high-resolution ultrasonography or MRI. Sensitivity and specificity for both USG and MRI for diagnosis of rotator cuff tear are almost similar but they are strongly correlated with  detection of partial thickness tear and full thickness tear.

Methods: A Prospective study of thirty patients undergoing Ultrasonography and Magnetic resonance imaging for patients having Frozen shoulder at SCB Medical college hospital after ethical clearance from Institutional Ethics committee and consents taken from patients. Detailed history, clinical examinations and routine investigations were done prior to radiological investigations.

Results: Partial thickness tear (PTT) as detected by USG were 11 out of 30 with sensitivity,   specificity, PPV, NPV, Likelihood+ve, Likelihood-ve, disease prevalence,diagnostic accuracy and diagnostic odds ratio being 58.3%,100%,100%,78.2%,58.3,0.42,60%,83.3% and 138.8 respectively whereas that of MRI were 65%,78%,100%,60%,2.95,0.44,59.7%,80% and 6.7. ROC Curve of USG and MRI for diagnosis of PTT revealed AUC as 0.4 and 0.6 respectively which has no discrimination for USG but MRI with AUC 0.6 had discrimination for PTT. Similarly for Full thickness tear(FTT), the diagnostic accuracy tests of USG and MRI were compared. The ROC curve and AUC  which revealed 0.5 for USG and 0.5 for MRI which proves no discrimination for the tests

Conclusion: Disease prevalence for rotator cuff tear in ultrasonography differs from MRI as sensitivity, specificity and diagnostic accuracy were more in MRI. Partial thickness tear diagnosed by USG were confirmed by MRI which had revealed more sensitivity, specificity, disease prevalence and diagnostic accuracy. Most of the diseases /pathologies significantly correlated with the diagnosis by MRI.