[OPPORTUNITIES OF ULTRASOUND IMAGING FOR VISUALIZATION OF THE SHOULDER JOINT PATHOLOGICAL CHANGES]

Aim of investigation - the assessment of opportunities of ultrasound (US) imaging for visualization of the shoulder joint pathological changes. 100 patients with the pathologies of shoulder joint have been investigated, they included traumatic, degenerative -dystrophic and inflammatory pathologies (tendinitis, tendinosis, tendinopathy, subacromial-subdelatoid bursitis).Ultrasound study performed on ultrasound TOSHIBA xario XG by high linear probe (7,5-12.0 MHz) with dopplerography(color, energetic), transverse and sagittal planes. It has been evaluated the thickness(diffuse, local), echostructure, continuity of contours of main shoulder joint tendons in above mentioned pathologies, in order to study their diagnostic values. 23 patients have been investigated by MRI which was used as "gold standard". The thickness, structure and continuity of contours of tendons have been evaluated by MRI in following regimes: T1, T2 and PDFs. In the study group the comparative results of ultrasound and MRI research were compared to determine the high diagnostic reliability of US, which is important for timely and effective treatment. The evaluation of US diagnostic accuracy for tendon thickness showed that the sensitivity was 95.00%, specificity - 66.67%, and diagnostic accuracy - 91.30%. It should be noted that negative likelihood ratio (NLR) is significant and equals to 0.08 (95% CI - 0.01÷0.60). The assessment of US diagnostic accuracy for tendon echostructure showed that the sensitivity was 94.74%, specificity - 50.00%, and diagnostic accuracy - 86.96%. It should be noted that negative likelihood ratio (NLR) is significant and equals to 0.11 (95% CI - 0.01÷0.60). The sensitivity of the evaluation of continuity of contours by US was 95.00%, specificity - 66.67%, diagnostic accuracy - 91.30%. It should be noted that negative likelihood ratio (NLR) is significant and equals to 0.08 (95% CI - 0.01÷0.60). On the basis of obtained results we can conclude that US may be characterized by high sensitivity, moderate specificity and high diagnostic accuracy for diagnostics of shoulder joint pathologies. It should be noted that mainly NLR is significant features for this imaging technique. US can be used in primary outpatient diagnostics, MRI and MR-arthrography should be performed in the hospital, to reveal the accompanying anomalies when planning surgical and/or other interventions.