[Value of sonography after rotator cuff repair: a comparison with MRI and clinical results]

How well do ultrasound- and MRI-results after rotator cuff reconstruction correlate with postoperative clinical findings?

Ultrasound- and MR-imaging of the afflicted shoulder on 40 patients who were surgically managed for isolated tear of the tendon of supraspinatus was performed at least 24 months after intervention. Patients were also clinically assessed. Based on the clinical result, sensitivity and specificity for the two imaging procedures was determined.

Only 11 (27.5%) patients had a completely inconspicuous ultrasonography. By ignoring the sonographic parameter "echogenicity" this number was raised to 29 (72.5%) patients. Without the above mentioned parameter ultrasonography demonstrated a good specificity (90.3%) yet a poor sensitivity (33.3%). Incorporation of "echogenicity" markedly weakened both values. MR-imaging showed an intact cuff in 32 (80%) patients, 5 (12.5%) had signs for a partial tear and in 3 (7.5%) a recurrent tear was diagnosed. Based on the clinical result, MR-imaging showed sufficient specificity (87.1%), yet also a poor sensitivity (44.4%).

After rotator cuff repair MRI- and ultrasound-findings frequently stand in distinct discrepancy to clinical results. Based on clinical findings, postoperative MR-imaging shows a slightly higher sensitivity than ultrasonography. Despite this, both radiographic methods do not allow deductions concerning the clinical outcome. The postoperative shoulder-scan and MRI should therefore be interpreted with utmost care. Symptoms and functional results are of high clinical relevance in the assessment of the postoperative shoulder.