Diagnostic performance of ultrasound for rotator cuff tears: a systematic review and meta-analysis

Rotator cuff (RC) tears are considered to be the main reason for shoulder pain. Although ultrasound is a useful method to detect it, its effectiveness when diagnosing RC tears has been a heated discussion. Therefore, we aimed at evaluating RC tears' ultrasound accuracy by conducting a systemically review and pooled comprehensive analysis.

Relevant articles up to May 2018 were searched from the Cochrane Library, Embase, and Pubmed databases. Either arthroscopy or magnetic resonance imaging (MRI) was considered as a reference standard. The results were estimated by pooled-sensitivity (P-SEN), pooled-specificity (P-SPE), pooled-diagnostic odds ratio (P-DOR), pooled-likelihood ratio+ (PLR+), pooled-likelihood ratio- (P-LR-), and the area under the summary receiver operating characteristic (SROC).

We selected seven prospective studies in accordance with the inclusion criteria that covered 554 rotator cuff tears in 868 patients. The P-SEN, P-SPE, P-LR+, P-LR-, P-DOR, area under the SROC curve of diagnostic performance of ultrasound for RC and post-test probability were 95% (95% CI: 88 - 98), 72% (95% CI: 61 - 81), 3.41 (95% CI: 2.40 - 4.84), 0.08 (95% CI: 0.03 - 0.16), 45.31 (95% CI: 21.04 - 97.59), 89% (95% CI: 0.86 - 0.91), and 46% and 2%, respectively.

Our metaanalysis demonstrates that ultrasound has a high efficiency for RC tears' diagnosis. It can be a promising method in patients with suspected RC tears because of its high sensitivity, specificity and diagnostic accuracy.