Are Shoulder Surgeons Any Good at Ultrasound ?

Authors: M Jeyam, L Funk, J Harris

References: Presented at SECEC 2006, Athens

Abstract
Introduction: High resolution ultrasound has gained increasing popularity as an aid in the diagnosis of rotator cuff pathology. With the advent of portable machines, ultrasound has become accessible to clinicians.

Aim: This study was conducted to evaluate the accuracy & reliability of ultrasound in diagnosing rotator cuff tears by a shoulder surgeon and comparing their ability to that of a musculoskeletal radiologist.

Methods: 64 patients undergoing shoulder arthroscopy for rotator cuff pathology underwent pre-operative ultrasonography (US). 35 in the shoulder surgeon group and 29 in the musculoskeletal radiologist's group. All patients were of similar demographics and pathology. The surgeon used a 10MHz portable linear array transducer and the radiologist used a 9-12MHz linear array probe on a static machine. Arthroscopic diagnosis was the reference standard to which ultrasound findings were compared.

Results: The sensitivity of ultrasound in detecting full thickness tears was similar for both the surgeon (92%) and the radiologist (94%). The radiologist had 100% sensitivity in diagnosing partial thickness tears, compared to 85.7% for the surgeon. The specificity for the surgeon was 94% and 62.5% for the radiologist.

Discussion: Our study shows that the surgeons are capable of diagnosing rotator cuff tears with the use of high-resolution ultrasound in the out-patient setting. The low specificity of ultrasound by the radiologist in this study could be attributed to the higher resolution machine detecting intra-substance tears that are not seen at shoulder arthroscopy.

Conclusion: Office ultrasound, by a trained clinician, is a powerful diagnostic tool in diagnosing rotator cuff tears and can be used effectively in running one-stop shoulder clinics.

Search ShoulderDoc.co.uk

This website is certified by Health On the Net Foundation. Click to verify. This site complies with the HONcode standard for trustworthy health information:
verify here.

ShoulderDoc.co.uk satisfies the INTUTE criteria for quality and has been awarded 'editor's choice'.

The material on this website is designed to support, not replace, the relationship that exists between ourselves and our patients. Full Disclaimer