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Supra-Short Ultrasound Protocol for Rotator Cuff Tears in the Emergency Department: Pilot Study.

Tony Zitek^1,2, Robert A Farrow¹, Michael Shalaby¹

¹Mount Sinai Medical Center, Department of Emergency Medicine, Miami Beach, Florida.

The Western Journal of Emergency Medicine

|November 5, 2025

Summary

Emergency physicians can quickly perform a simplified shoulder ultrasound protocol for rotator cuff tears. However, minimal training yielded moderate accuracy, indicating a need for further education before widespread clinical adoption.

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Area of Science:

Emergency Medicine
Diagnostic Imaging
Musculoskeletal Ultrasound

Background:

Rotator cuff tears are common and accurately diagnosed with ultrasound.
Ultrasound is underutilized by emergency physicians for rotator cuff tear diagnosis.
A simplified protocol may increase emergency physician use of ultrasound.

Purpose of the Study:

To develop a simplified shoulder ultrasound protocol (supra-short protocol) for emergency physicians.
To assess the preliminary diagnostic accuracy of this protocol for supraspinatus tears.

Main Methods:

A pilot diagnostic accuracy study was conducted.
Minimally trained emergency physicians performed the supra-short protocol on volunteers.
A sports medicine physician performed a complete ultrasound as the criterion standard.

Main Results:

The supra-short protocol had a sensitivity of 66.7% and specificity of 87.1% for supraspinatus tears.
Emergency physicians completed scans in a median of 133 seconds.
80% of images were deemed adequate upon expert review.

Conclusions:

Emergency physicians can rapidly perform the supra-short ultrasound protocol after minimal training.
The protocol demonstrated moderate accuracy in identifying supraspinatus tears.
More extensive training is likely necessary for effective clinical implementation.