[Echography in diseases of the rotator cuff]

The diagnostic accuracy of shoulder US was investigated in 69 patients with a "painful shoulder" and the results compared with those of MR imaging. In our experience, US exhibited 95% sensitivity, 69% specificity, 83% positive predictive value, 90% negative predictive value and 85% accuracy. The analysis of the single US patterns proved the difficult distinction of small tears from focal tears, whereas complete ruptures were always easy to identify. In summary, all cases of rotator cuff degeneration or tear were always detected but not always correctly identified. False negatives on US included inflammatory processes of cuff structures but never ruptures or degenerations. Therefore, in our diagnostic protocol, US appeared to be a valuable screening method in the exclusion of rotator cuff injuries; other imaging techniques--i.e., arthrography, MR imaging, arthroscopy--were employed only in questionable/positive cases on US.