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Site and size of rotator-cuff tear. Findings at ultrasound, double-contrast arthrography, and computed tomography
P U Farin1, E Kaukanen, H Jaroma
1Department of Clinical Radiology, Kuopio University Hospital, Finland.
Rationale And Objectives:
The authors discuss findings of ultrasound (US), double-contrast arthrography (AG), and contrast computed tomography arthrography (CTA) in assessing precise site and size of rotator-cuff tears.
Methods:
Eighty-six patients were compared prospectively in a masked fashion; the results of surgery were studied in 25 patients and the results of arthroscopy were studied in 61 patients.
Results:
Ultrasound detected 80% (8 of 10) of the partial-thickness tears and 90% (18 of 20) of the full-thickness tears. Arthrography and CTA had identical results with 70% sensitivity (7 of 10) in partial-thickness tears; AG showed 90% (18 of 20) and CTA 95% (19 of 20) of the full-thickness tears. Arthrography had two false-positive findings, and US and CTA had one each. The size of a tear could be evaluated correctly with AG in 30% (9 of 30), with US in 70% (21 of 30) and with CTA in 76% (23 of 30). More extensive tears were encountered at US than had been found at surgery in 2% (2 of 86) and less extensive tears in 9% (8 of 86); CTA depicted more extensive tears in 2% (2 of 86) and less extensive tears in 6% (6 of 86), respectively. The site of a tear could be evaluated with AG in 30% (9 of 30); US and CTA showed the site correctly in every patient in which the tear could be diagnosed.
Conclusion:
Ultrasound and CTA were equally accurate in diagnosing and evaluating the size and site of rotator-cuff tears. Double-contrast AG was less accurate in the diagnosis of tears and the size and site of tears clearly could be assessed worse.