Diagnostic accuracy of high-resolution ultrasonography for detection of rotator cuff tear with respect to magnetic resonance imaging

Syed Athaulla; Atik Ahmed; Mansuri Vahab Mohammedharun; Sayed Hussain

doi:10.18203/issn.2455-4510.IntJResOrthop20263910

Authors

Syed Athaulla Department of Radiology, Al Ameen Medical College, Bijapur, Karnataka, India
Atik Ahmed Department of Radiology, Al Ameen Medical College, Bijapur, Karnataka, India
Mansuri Vahab Mohammedharun Department of Radiology, Al Ameen Medical College, Bijapur, Karnataka, India
Sayed Hussain Department of Radiology, Al Ameen Medical College, Bijapur, Karnataka, India

DOI:

https://doi.org/10.18203/issn.2455-4510.IntJResOrthop20263910

Keywords:

Rotator cuff tear, Ultrasonography, MRI, Supraspinatus, Shoulder injury, Diagnostic accuracy

Abstract

Background: Rotator cuff tears are a common cause of shoulder pain; although magnetic resonance imaging (MRI) is the diagnostic gold standard, this study evaluated high-resolution ultrasonography as a cost-effective, non-invasive alternative for detecting rotator cuff tears.

Methods: A prospective cross-sectional study was conducted at the Department of Radiodiagnosis, Al-Ameen Medical College, Bijapur, from 2023 to 2025. Sixty-five patients aged 18–49 years with suspected rotator cuff injury underwent high-resolution ultrasonography (HRUS) followed by MRI. Findings from both modalities were compared for tendon pathology, including complete and partial tears, tendinosis, and normal appearances.

Results: High-resolution ultrasonography detected partial-thickness rotator cuff tears in 20 patients (20/65, 30.8%) and complete tears in 17 patients (17/65, 26.2%), whereas MRI identified partial tears in 23 patients (23/65, 35.4%) and complete tears in 22 patients (22/65, 33.8%). The supraspinatus tendon was the most commonly involved tendon, affected in 28 patients (28/65, 43.1%). For complete supraspinatus tears, ultrasonography demonstrated high diagnostic performance, with a sensitivity of 83.1%, specificity of 97.4%, positive predictive value of 99.4%, negative predictive value of 96.7%, and a Kappa value of 0.90, indicating almost perfect agreement with MRI. However, ultrasonography showed reduced sensitivity and lower agreement for partial-thickness tears and for infraspinatus tendon involvement.

Conclusion: High-resolution USG is a reliable first-line modality for detecting complete rotator cuff tears, particularly of the supraspinatus and subscapularis tendons; however, MRI remains essential for evaluating partial and posterior tendon tears when USG findings are inconclusive.

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