Diagnostic difficulties in the radiological assessment of subscapularis tears

Radiological evaluation of rotator cuff tears are sensitive and specific. Accuracy may be low in diagnosing subscapularis tears.

We retrospectively reviewed shoulder arthroscopies performed by two surgeons over 45 months. We reviewed patients who had subscapularis repairs and their preoperative imaging.

286 cases had imaging (193 MRIs, 93 USS) with 77 subscapularis repairs. MRI suggested 31 tears, arthroscopy confirmed 16 (30% sensitivity, 89% specificity). USS suggested 6 tears, arthroscopy confirmed 4 (13% Sensitivity, 97% specificity).

Results demonstrated low accuracy for preoperative radiological subscapularis tear assessment. This has logistical, diagnostic and implications on treatment.