Traumatology and Orthopedics of RussiaTraumatology and Orthopedics of Russia2311-29052542-0933Vreden National Medical Research Center of Traumatology and Orthopedics152710.21823/2311-2905-2020-26-4-102-111Magnetic Resonance Imaging Identification of Rotator Cuff Pathology: Inter-rater RealibiltyLogvinovA. N.<p>Aleksey N. Logvinov — Orthopedic Surgeon</p><p>Moscow</p>logvinov09@gmail.comhttps://orcid.org/0000-0003-3235-5407MakarievaO. V.<p>Oksana V. Makarieva — Orthopedic Surgeon</p><p>Moscow</p>aksan-a@mail.ruhttps://orcid.org/0000-0002-5187-8062IlʼinD. O.<p>Dmitrii O. Ilʼin — Cand. Sci. (Med.), Orthopedic Surgeon, Trauma Surgeon of European Clinic of Sports Traumatology and Orthopaedics (ECSTO); Assistant, Department of Traumatology and Orthopaedics, RUDN University</p><p>Moscow</p>ilyinshoulder@gmail.comhttps://orcid.org/0000-0003-2493-4601KadantsevP. M.<p>Pavel M. Kadantsev — PhD Student</p><p>Moscow</p>dr.kadantsev.pavel@emcmos.ruhttps://orcid.org/0000-0002-8027-3898ZaripovA. R.<p>Aziz R. Zaripov — PhD Student</p><p>Moscow</p>azaripov@emcmos.ruhttps://orcid.org/0000-0003-1282-3285FrolovA. V.<p>Aleksandr V. Frolov — Cand. Sci. (Med.), Orthopedic Surgeon, European Clinic of Sports Traumatology and Orthopaedics (ECSTO); Assistant Professor, Department of Traumatology and Orthopaedics, RUDN University</p><p>Moscow</p>a.frolov1980@gmail.comhttps://orcid.org/0000-0002-2973-8303MagnitskayaN. E.<p>Nina E. Magnitskaya — Cand. Sci. (Med.), Orthopedic Surgeon</p><p>Moscow</p>nmagnitskaya@emcmos.ruhttps://orcid.org/0000-0002-4336-036XRyazantsevM. S.<p>Mikhail S. Ryazantsev — Cand. Sci. (Med.), Orthopedic Surgeon</p><p>Moscow</p>mryazantsaev@emcmos.ruhttps://orcid.org/0000-0002-9333-5293BurtsevM. E.<p>Mikhail E. Burtsev — Orthopedic Surgeon</p><p>Moscow</p>drburtsev91@gmail.comhttps://orcid.org/0000-0003-1614-1695KorolevA. V.<p>Andrey V. Korolev — Dr. Sci. (Med.), Chief Doctor, European Clinic of Sports Traumatology and Orthopaedics (ECSTO); Professor, Department of Traumatology and Orthopaedics, RUDN University</p><p>Moscow</p>akorolev@emcmos.ruhttps://orcid.org/0000-0002-8769-9963European Clinic of Sports Traumatology and Orthopedics (ECSTO)RUDN University161220202641021112809202020112020Copyright © ,<strong>Background</strong>. The shoulder MRI is one of the main methods for the rotator cuff injuries diagnostics and determination of the further treatment tactics. The agreement in the MRI data interpretation among specialists regarding different types of shoulder ruptures is an integral part of diagnostic test validity evaluation. <strong>The purpose of this study</strong> was to assess the agreement in the MRI data interpretation in the patients with shoulder rotator cuff pathology among trauma surgeons, as well as between trauma surgeons and a radiologist. <strong>Materials and Methods</strong>. The study was a retrospective analysis of the MRI data and surgical reports regarding 57 patients with various shoulder pathologies undergone the shoulder MRI and arthroscopic shoulder revisions in the period from 2017 to 2019. There were 38 (67%) men and 19 (33%) women among the patients. The average age of the patients was 52.7±13.6 years. The sensitivity and specificity, as well as the shoulder MRI inter-rater reliability were assessed in the course of the study. <strong>Results</strong>. The rotator cuff pathology was revealed in 52 patients: supraspinatus tendon injury in 98% of cases, supraspinatus and infraspinatus tendon — in 26%, isolated subscapularis tendon injury — in 2%, supraspinatus and subscapularis tendon — in 39%. The maximal concordance in the MRI data interpretation was achieved in the patients with full-thickness supraspinatus tendon rupture, as well as with the supraspinatus tendon calcifications. However, significant disagreement was found between orthopedists with different work experience in determination of the presence and type of infraspinatus and subscapularis tendons pathology and supraspinatus tendon incomplete ruptures and tendinitis. <strong>Conclusion</strong>. The high agreement in the MRI data interpretation in determining the pathology of the shoulder rotator cuff among trauma surgeons, as well as between trauma surgeons and radiologists, was observed only regarding the supraspinatus tendon, calcifying tendonitis and full-thickness injury. The diagnosis of tendinitis and incomplete tendon rupture remains difficult. Their interpretation results vary greatly. It is also worth noting the heterogeneity of the results of diagnostics of the infraspinatus and subscapularis tendon pathology.rotator cuffshoulderMRIinter-rater reliabilityвращательная манжетаплечевой суставМРТмежэкспертная надежность[1. Matava M.J., Purcell D.B., Rudzki J.R. Partial-thickness rotator cuff tears. Am J Sports Med. 2005;33(9):14051417. doi: 10.1177/0363546505280213.][2. Sharma G., Bhandary S., Khandige G., Kabra U. MR Imaging of Rotator Cuff Tears: Correlation with Arthroscopy. J Clin Diagn Res. 2017;11(5):TC24-TC27. doi: 10.7860/JCDR/2017/27714.9911.][3. Мурашина И.В., Егорова Е.А., Савицкий П.П., Хасаншин М.М., Дедюрин А.А. Возможности магнитно-резонансной томографии в диагностике последствий повреждений плечевого сустава. Медицинский вестник МВД. 2011;4(53):15-20.][4. Khazzam M., Kuhn J.E., Mulligan E., Abboud J.A., Baumgarten K.M., Brophy R.H. et al. Magnetic resonance imaging identification of rotator cuff retears after repair: interobserver and intraobserver agreement. Am J Sports Med. 2012;40(8):1722-1727. doi: 10.1177/0363546512449424.][5. Spencer E.E. Jr., Dunn W.R., Wright R.W., Wolf B.R., Spindler K.P., McCarty E. et al. Interobserver agreement in the classification of rotator cuff tears using magnetic resonance imaging. Am J Sports Med. 2008;36(1):99-103. doi: 10.1177/0363546507307504.][6. Xiao J.,Cui G.Q., Wang J.Q. Diagnosis of bursal-side partialthickness rotator cuff tears. Orthop Surg. 2010;2(4):260-265. doi: 10.1111/j.1757-7861.2010.00097.x.][7. Гончаров Е.Н., Акимкина А.М., Знаменский И.А., Чибисов С.М., Лисаченко И.В., Юматова Е.А. Магнитно-резонансная томография в диагностике повреждений мягкотканных структур плечевого сустава. Фундаментальные исследования. 2012; (7, ч. 1):76-79.][8. Smith T.O., Daniell H., Geere J.A., Toms A.P., Hing C.B. The diagnostic accuracy of MRI for the detection of partial- and full-thickness rotator cuff tears in adults. Magn Reson Imaging. 2012;30(3):336-346. doi: 10.1016/j.mri.2011.12.008.][9. Логвинов А.Н., Ильин Д.О., Каданцев П.М., Макарьева О.В., Бурцев М.Е., Рязанцев М.С., Магнитская Н.Е., Фролов А.В., Королев А.В. Особенности диагностики частичных разрывов вращательной манжеты плечевого сустава. Травматология и ортопедия России 2019;25(2):143-149. doi: 10.21823/2311-2905-2019-25-2-143-149.][10. Jain N.B., Collins J., Newman J.S., Katz J.N., Losina E., Higgins L.D. Reliability of magnetic resonance imaging assessment of rotator cuff: the ROW study. PM R. 2015;7(3):245-254. doi: 10.1016/j.pmrj.2014.08.949.][11. Balich S.M., Sheley R.C., Brown T.R., Sauser D.D., Quinn S.F. MR imaging of the rotator cuff tendon: interobserver agreement and analysis of interpretive errors. Radiology. 1997;204(1):191-194. doi: 10.1148/radiology.204.1.9205245.][12. Robertson P.L., Schweitzer M.E., Mitchell D.G., Schlesinger F., Epstein R.E., Frieman B.G., Fenlin J.M. Rotator cuff disorders: interobserver and intraobserver variation in diagnosis with MR imaging. Radiology. 1995;194(3):831-835. doi: 10.1148/radiology.194.3.7862988.][13. Grant J.A., Miller B.S., Jacobson J.A., Morag Y., Bedi A., Carpenter J.E., MOON Shoulder Group. Intraand inter-rater reliability of the detection of tears of the supraspinatus central tendon on MRI by shoulder surgeons. J Shoulder Elbow Surg. 2013;22(6):725-731. doi: 10.1016/j.jse.2012.08.011.][14. Madden M.E. The magic-angle effect of the supraspinatus tendon. Radiol Technol. 2006;77(5):357-365.][15. Van Dyck P., Gielen J.L., Veryser J., Weyler J., Vanhoenacker F.M., Van Glabbeek F. et al. Tears of the supraspinatus tendon: assessment with indirect magnetic resonance arthrography in 67 patients with arthroscopic correlation. Acta Radiol. 2009;50(9):10571063. doi: 10.3109/02841850903232723.]