Diagnostic Accuracy of Ultrasound in the Diagnosis of Rotator Cuff Tear Taking Magnetic Resonance Imaging as the Gold Standard
DOI:
https://doi.org/10.70749/ijbr.v3i6.2688Keywords:
Rotator Cuff Tear, Ultrasound, Magnetic Resonance Imaging, Diagnostic Accuracy, Sensitivity and SpecificityAbstract
Background: Rotator cuff tear is a frequent cause of shoulder pain and functional limitation. Ultrasound is widely used for initial assessment, whereas magnetic resonance imaging is commonly treated as the reference modality for rotator cuff pathology. Aim: To determine the diagnostic accuracy of ultrasound in diagnosing rotator cuff tear using magnetic resonance imaging as the gold standard. Material and Methods: A cross sectional survey was conducted in the Department of Diagnostic Radiology, Combined Military Hospital, Lahore, over six months (October 2024 to March 2025). Non probability consecutive sampling was used. Sample size was 67, calculated at 95% confidence interval using expected sensitivity 100%, specificity 92.68%, margins of error 5% and 7%, and prevalence of complete tear 24.0%. Patients aged 25 to 60 years with shoulder pain causing pain on elevation of the arm with limitation of movements were included. Ultrasound was performed on a Logic P9 machine using a 3 to 12 MHz probe, followed by 1.5 Tesla magnetic resonance imaging. A 2×2 table was used to calculate sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy, with stratified recalculation by age, gender, laterality, and occupation. Results: Mean age was 44.9 ± 9.2 years. Males were 39 (58.2%) and females 28 (41.8%). Magnetic resonance imaging detected rotator cuff tear in 34 (50.7%) including 16 (23.9%) complete and 18 (26.9%) partial tears. Ultrasound detected tear in 35 (52.2%) including 15 (22.4%) complete and 20 (29.9%) partial tears. True positives were 31, true negatives 29, false positives 4, and false negatives 3. Sensitivity was 91.2%, specificity 87.9%, positive predictive value 88.6%, negative predictive value 90.6%, and diagnostic accuracy 89.6%. Conclusion: Ultrasound showed high diagnostic accuracy versus magnetic resonance imaging and supported its use as a first line investigation in suspected rotator cuff tear.
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