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The significance of subacromial arthrography to verify partial bursal-side rotator cuff ruptures
Thomas L Schneider1, Rüdiger Schmidt-Wiethoff, Wolf Drescher
1Clinic for Orthopedics and Sport Traumatology, Dreifaltigkeitskrankenhaus, Aachenerstr. 445-449, 50933 Cologne, Germany. tom_schneider62@hotmail.com
Background:
The purpose of this study was to verify a partial bursa-side rupture of the rotator cuff (RC) using different imaging techniques with special emphasis on the validity of a specific method of subacromial arthrography (SAA).
Methods:
Patients (n=92, mean age 53.8 years) with a subacromial impingement syndrome underwent sonography, magnetic resonance imaging (MRI), and SAA. All diagnostic results were checked by subsequent arthroscopic surgery.
Results:
Of 31 surgically verified ruptures, 17 showed a partial rupture located towards the bursa. These had been detected by MRI and ultrasound with a sensitivity of 64% and 41%, respectively, while SAA as a diagnostic tool yielded a sensitivity of 82%. In 14 cases of complete RC ruptures, all imaging techniques had a similar sensitivity of 86-93%.
Conclusion:
It appears that SAA is an adequate and valid diagnostic tool for the detection of partial bursa-sided RC ruptures. Ultrasound and MRI showed a comparably lower sensitivity. It is therefore concluded that SAA has clear advantages in the diagnosis of this defect with the consequence that open surgical techniques can be avoided.