Rotator Cuff Imaging - Ian McDermott 14/11/2000
(MRI vs ULTRASOUND)
Introduction
Arthrography is the gold standard in imaging of the rotator cuff. Reported accuracy of 98 - 99% [Mink,
Radiology
1985; 157: 621]. But = invasive.
Disadvantage of US is that it is very operator dependent and does not allow visualisation of the entire cuff. US has been reported to have sensitivity and specificity > 90% [Crass,
J Clin Ultrasound
1988; 16(5): 313].
MRI takes a long time, is expensive may be unsuccessful in very large or claustrophobic patients (7% unable to have MRI due to claustrophobia [Burke
AJR
1989 - see below]).
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Brief
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MINIACI THE AMERICAN JOURNAL OF SPORTS MEDICINE 1995
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Author
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Miniaci A, Dowdy PA, Willits KR, Vellet AD University of Western Ontario, London, Canada
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Title
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Magnetic Resonance Imaging Evaluation of the Rotator Cuff Tendons in the Asymptomatic Shoulder
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Reference
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Am. J. Sports Med. (1995), 23; 2: 142 - 145
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Summary
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In 30 MRI scanned asymptomatic shoulders. For the supraspinatus tendon, NONE were normal, 23% appeared to have 'partial tears', None showed complete tears. Similar results for infraspinatus and subscapularis. All teres minor tendons were normal. SUMMARY - non-enhanced MRI may be of little value in investigating suspected PARTIAL tears.
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Critique
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Blinded. Senior musculoskeletal radiologist. 'Not told that patients were asymptomatic.'
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