Correlation of Preoperative MRI and Shoulder-Specific Tests With Intraoperative Findings in Rotator Cuff Tears

The aim of this study was to compare preoperative magnetic resonance imaging (MRI) findings, shoulder tests, and intraoperative observations in patients who underwent arthroscopic rotator cuff (RC) repair at a single center in Turkey. A total of 162 patients diagnosed with rotator cuff tears (RCTs) were included in this study. The physical examination involved the Jobe, Neer, and drop-arm tests. For patients undergoing shoulder arthroscopy, tear type and stage were evaluated intraoperatively and classified as partial-thickness or full-thickness tears. Preoperative assessments using MRI documented tear types and stages. Test results and imaging findings were compared to intraoperative observations to ensure diagnostic accuracy. A study of shoulder arthroscopy patients (129 right, 33 left; mean age 58.19 ± 9.20 years) found that 77.2% had full-thickness tears and 22.8% had partial tears on preoperative MRI. Significant differences were noted in the drop-arm test results (p = 0.003). MRI proved less reliable in localizing partial RCTs. Grade changes in full-thickness tears (Patte classification, p < 0.001) and partial tears (Ellman classification, p = 0.018) were statistically significant between preoperative and intraoperative evaluations. Certain specialized shoulder tests demonstrate strong diagnostic accuracy for specific conditions; however, their effectiveness may be limited when applied in isolation. MRI is a reliable tool for diagnosing RCTs; however, its sensitivity is reduced when detecting partial tears. This discrepancy suggests that both full-thickness and partial tears may exhibit more advanced pathology at the time of surgical intervention than initially indicated by preoperative imaging.