Rotator Cuff Tears; Correlation Between Clinical Findings, MRI and Arthroscopic Findings
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Original Article
VOLUME: 57 ISSUE: 4
P: 414 - 420
December 2019

Rotator Cuff Tears; Correlation Between Clinical Findings, MRI and Arthroscopic Findings

Med Bull Haseki 2019;57(4):414-420
1. Sağlık Bilimleri Üniversitesi, Haseki Eğitim ve Araştırma Hastanesi, Ortopedi ve Travmatoloji Kliniği, İstanbul, Türkiye
2. Düzce Atatürk Devlet Hastanesi, Ortopedi ve Travmatoloji Kliniği, Düzce, Türkiye
No information available.
No information available
Received Date: 22.07.2019
Accepted Date: 29.07.2019
Publish Date: 10.12.2019
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ABSTRACT

Aim:

The aim of this retrospective study was to compare the results of clinical examination and magnetic resonance imaging (MRI) with arthroscopic findings, to evaluate the role of rotator cuff (RC) examination tests in diagnosis and to reveal the agreement between observers.

Methods:

Our study included 48 patients who underwent surgery for RC rupture between March 2015 and April 2016 in the Orthopedics and Traumatology Clinic at Haseki Training and Research Hospital. All patients had a clinical examination performed by a shoulder surgeon, an orthopedist and a senior resident. Jobe’s supraspinatus test and the painful arc test were used for rotator cuff tears during physical examination. Physical examination and MRI findings were compared with the arthroscopic findings.

Results:

Jobe’s supraspinatus evaluations showed moderate agreement between the participants, while painful arc evaluations showed poor between shoulder surgeon and specialist-assistant, and moderate between specialist and assistant. There was a statistically significant difference between the results of clinical examination done by the shoulder surgeon and MRI and arthroscopy results. Moderate correlation was found between arthroscopy and MRI results.

Conclusion:

Our results showed that clinical evaluation is insufficient in establishing the diagnosis of RC tear in a painful shoulder. MRI can be used safely in the diagnosis of RM tear, but its sensitivity is low in partial tears.

Keywords:
Shoulder arthroscopy, MRI, rotator cuff tear

References

1
Oh LS, Wolf BR, Hall MP, et al. Indications for rotator cuff repair: a systematic review. Clin Orthop Relat Res 2007;455:52-63.
2
Royal College of General Practitioners. Office of Population Census and Surveys, Department of Health and Social Security. Morbidity statistics from general practice. Third national study:socio-economic analyses. London: HMSO, 1986 (Series MB5 No 2).
3
Bjelle A. Epidemiology of shoulder problems. Baillieres Clin Rheumatol 1989;3:437-51.
4
Morag Y, Jacobson JA, Miller B, et al. MR imaging of rotator cuff injury: what the clinician needs to know. Radiographics 2006;26:1045-65.
5
Morrison DS, Ofstein R. The use of magnetic resonance imaging in the diagnosis of rotator cuff tears. Orthopedics 1990;13:633-77.
6
Iannotti JP, Zlatkin MB, Esterhai JL, et al. Magnetic resonance imaging of the shoulder. Sensitivity, specificity, and predictive value. J Bone Joint Surg Am 1991;73:17-29.
7
Ejnisman B, Andreoli CV, Soares BG, et al. Interventions for tears of the rotator cuff in adults. Cochrane Database Syst Rev 2004;CD002758.
8
Michener LA, Walsworth MK, Burnet EN. Effectiveness of rehabilitation for patients with subacromial impingement syndrome: a systematic review. J Hand Ther 2004;17:152-64.
9
Itoi E, Minagawa H, Sato T, Sato K, Tabata S Isokinetic Strength after Tears of the Supraspinatus Tendon. The Journal of Bone and Joint Surgery 1997;79B:77-82.
10
Kessel L, Watson M. The painful arc syndrome. Clinical classification as a guide to management. J Bone Joint Surg Br 1977;59:166-72.
11
Jobe FW, Moynes DR. Delineation of diagnostic criteria and a rehabilitation program for rotator cuff injuries. Am J Sports Med 1982;10:336-9.
12
Gartsman GM, Milne JC. Articular surface partialthickness rotator cuff tears. J Shoulder Elbow Surg 1995;4:409-15.
13
Landis JR, Koch GG. The measurement of observer agreement for categorical data. Biometrics 1977;33:159-74.
14
De Winter AF, Jans MP, Scholten RJPM, Deville´ W, van Schaardenburg D, Bounter LM. Diagnostic classification of shoulder disorders: interobserver agreement and determinants of disagreement. Ann Rheum Dis 1999;58:272-7.
15
Liesdek C, van der Windt DAWM, Koes BW, Bouter LM. Soft-tissue disorders of the shoulder: a study of inter-observer agreement between general practitioners and physiotherapists and an overview of physiotherapeutic treatment. Physiotherapy 1997;83:12-17.
16
Bamji AN, Erhardt CC, Price TR, Williams PL. The painful shoulder: can consultants agree? Br J Rheumatol 1996;35:1172-4.
17
Ostor AJ, Richards CA, Prevost AT, Hazleman BL, Speed CA. Interrater reproducibility of clinical tests for rotator cuff lesions. Ann Rheum Dis 2004;63:1288-92.
18
Michener LA, Walsworth MK, Doukas WC, Murphy K P. Reliability and diagnostic accuracy of 5 physical examination tests and combination of tests for subacromial impingement. Arch Phys Med Rehabil 2009;90:1898-903.
19
Leroux JL, Thomas E, Bonnel F, Blotman F. Diagnostic value of clinical tests for shoulder impingement syndrome. Rev Rhum (Engl Ed) 1995;62:423-8.
20
Hertel R, Ballmer FT, Lombert SM, Gerber C. Lag signs in the diagnosis of rotator cuff rupture. J Shoulder Elbow Surg 1996;5:307-13.
21
Norwood LA, Barrack R, Jacobson KE. Clinical presentation of complete tear of the rotator cuff. J Bone Joint Surg [Am] 1989;71:499-505.
22
Norregaard J, Krogsgaard MR, Lorenzen T, et al. Diagnosisng patients with longstanding shoulder joint pain. Ann Rheum Dis 2002;61:646-50.
23
Sher JS, Uribe JW, Posada A, Murphy BJ, Zlatkin MB. Abnormal findings on magnetic resonance images of asymptomatic shoulders. J Bone Joint Surg [Am] 1995;77:10-5.
24
Milgrom C, Schaffler M, Gilbert S, van Holsbeeck M. Rotator-cuff changes in asymptomatic adults. J Bone Joint Surg [Br] 1995;77:296-8.
25
Silva L, Andréu JL, Muñoz P, et al. Accuracy of physical examination in subacromial impingement syndrome. Rheumatology (Oxford) 2008;47:679-83.
26
Clark JM, Harryman DT. Tendons, ligaments, and capsule of the rotator cuff. Gross and microscopic anatomy. J Bone Joint Surg Am 1992;74:713-25.
27
Ure BM, Tiling T, Kirchner R, Rixen D. Reliability of clinical examination of the shoulder in comparison with arthroscopy. A prospective study. Unfallchirurg 1993;96:382-6.
28
Lenza M, Buchbinder R, Takwoingi Y, Johnston RV, Hanchard NC, Faloppa F. Magnetic resonance imaging, magnetic resonance arthrography and ultrasonography for assessing rotator cuff tears in people with shoulder pain for whom surgery is being considered. Cochrane Database Syst Rev 2013;CD009020.
29
Dinnes J, Loveman E, McIntyre L, Waugh N. The effectiveness of diagnostic tests for the assessment of shoulder pain due to soft tissue disorders: a systematic review. Health Technology Assessment (Winchester, England) 2003;7:1-166.
30
Sela Y, Eshed I, Shapira S, et al. Rotator cuff tears: correlation between geometric tear patterns on MRI and arthroscopy and pre- and postoperative clinical findings. Acta Radiol 2015;56:182-9.