Assessment of rotator cuff prior to shoulder arthroplasty
Prior to shoulder arthroplasties, magnetic resonance imaging (MRI) is used to establish the condition of the surrounding soft tissue structures. Up to date MSK ultrasound has only been considered as an additional examination tool in the preoperative assessment, mainly because previous studies have shown non-satisfying results especially in patients with chronic and degenerative changes. However, MSK ultrasound has many advantages compared to MRI: it is inexpensive, quick, easily available and applicable.
The authors of this study tried to establish the accuracy and the usefulness of MSK ultrasound to 3T MRI in detecting pathologies of the rotator cuff and the long head biceps tendon prior to joint replacement.
MSK ultrasound had a sensitivity between 0, 88 and 0, 95 for detection of any supraspinatus, infraspinatus and long biceps tendon damage and the specificity ranged between 0.8 and 1. MSK ultrasound was less accurate in the detection of any subscapularis damage (sensitivity: 0.78), possibly due to the limited external rotation ability in patients with osteoarthritis. The authors therefore concluded that MSK ultrasound is mainly useful in patients with MRI exclusion criteria.
> From: Fisher et al., J Orthop 12 (2015) 23-30. All rights reserved to Elsevier Ltd.. Click here for the Pubmed summary.
Video: Supraspinatus tendon Ultrasound exam:
Video: Rotator cuff MRI: