Features of Partial Rotator Cuff Tears Diagnostics

Cover Page


Cite item

Full Text

Abstract

Partial rotator cuff tears are the most common pathology of the shoulder joint. Diagnostic of such conditions is a challenging problem for trauma surgeon.

Purpose of the study is to analyze the diagnostic significance of manual tests and the standard MRI of the shoulder joint.

Materials and Methods. The study is a retrospective analysis of disease history data of 25 patients (15 males, 10 females) treated at the authors’ hospital during the period from 2014 to 2017. Examination was performed according to a standard protocol: assessment of shoulder range of motion, palpation, manual examination, including “full/empty can” test, a painful arc symptom and the Hawkins – Kennedy test. All patients underwent MRI of the shoulder joint. The mean age of patients was 50.8 years. Shoulder joint arthroscopic inspection was considered the gold standard for diagnostics.

Results. After data analysis, the following results were obtained: sensitivity of the “full can” test was 68%, the accuracy was 68%; “empty can” test sensitivity and accuracy were 76%, respectively. MRI sensitivity for diagnostics of supraspinatus tendon ruptures was 84% with the accuracy of 84%. The combination of the Hawkins – Kennedy test with the symptom of painful arch demonstrated accuracy and sensitivity of 64%. The study evaluated the effectiveness of MRI for diagnostic of the rupture type: sensitivity for injury from the joint surface — 80%, from the subacromial space — 70%; specificity for ruptures from the articular surface — 90% and from the subacromial space — 93%. The accuracy was 84% for both types of ruptures.

Conclusions. Combined application of manual tests and MRI of the shoulder joint allows to diagnose partial rotator cuff tears in the majority of cases.

About the authors

A. N. Logvinov

European Clinic of Sports Traumatology and Orthopedics (ECSTO); Peoples Friendship University of Russia

Author for correspondence.
Email: alogvinov@emcmos.ru

Aleksei N. Logvinov — orthopedic surgeon, ECSTO; postgraduate student, Department of Traumatology, Orthopaedics

Moscow

Россия

D. O. Ilyin

European Clinic of Sports Traumatology and Orthopedics (ECSTO)

Email: fake@neicon.ru

Dmitrii O. Ilʼin — cand. Sci. (Med.), orthopedic surgeon

Moscow

Россия

P. M. Kadantsev

European Clinic of Sports Traumatology and Orthopedics (ECSTO); Peoples Friendship University of Russia

Email: fake@neicon.ru

Pavel M. Kadantsev — resident, Peoples Friendship University of Russia; trainee, ECSTO

Moscow

Россия

O. V. Makarieva

European Clinic of Sports Traumatology and Orthopedics (ECSTO)

Email: fake@neicon.ru

Oksana V. Makarieva — orthopedic surgeon

Moscow

Россия

M. E. Burtsev

European Clinic of Sports Traumatology and Orthopedics (ECSTO)

Email: fake@neicon.ru

Mikhail E. Burtsev — orthopedic surgeon

Moscow Россия

M. S. Ryazantsev

European Clinic of Sports Traumatology and Orthopedics (ECSTO)

Email: fake@neicon.ru

Mikhail S. Ryazantsev — cand. Sci. (Med.), orthopedic surgeon

Moscow Россия

N. E. Magnitskaya

European Clinic of Sports Traumatology and Orthopedics (ECSTO)

Email: fake@neicon.ru

Nina E. Magnitskaya — cand. Sci. (Med.), orthopedic surgeon

Moscow Россия

A. V. Frolov

European Clinic of Sports Traumatology and Orthopedics (ECSTO); Peoples Friendship University of Russia

Email: fake@neicon.ru

Aleksandr V. Frolov — cand. Sci. (Med.), orthopedic surgeon, ECSTO; assistant professor, Department of Traumatology, Orthopaedics

Moscow

Россия

A. V. Korolev

European Clinic of Sports Traumatology and Orthopedics (ECSTO); Peoples Friendship University of Russia

Email: fake@neicon.ru

Andrey V. Korolev — Dr. Sci. (Med.), chief doctor, ECSTO; professor, Department of Traumatology and Orthopaedics

Moscow

Россия

References

  1. Ostor A.J., Richards C.A., Prevost A.T., Speed C.A., Hazleman B.L. Diagnosis and relation to general health of shoulder disorders presenting to primary care. Rheumatology (Oxford). 2005;44(6):800-805. doi: 10.1093/rheumatology/keh598.
  2. Matava M.J., Purcell D.B., Pudzki J.R. Partial-thickness rotator cuff tears. Am J Sports Med. 2005;33(9):1405-1417. doi: 10.1177/0363546505280213.
  3. Naredo E., Aguado P., Miguel E.D., Uson J., Mayordomo L., Gijon-Baños J., Martin-Mola E. Painful shoulder: comparison of physical examination and ultrasonographic findings. Ann Rheum Dis. 2002;61(2):132-136. doi: 10.1136/ard.61.2.132.
  4. 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.
  5. Matthewson G., Beach C.J., Nelson A.A., Woodmass J.M., Ono Y., Boorman R.S. et al. Partial Thickness Rotator cuff Tears: current concepts. Adv Orthop. 2015;2015:458786. doi: 10.1155/2015/458786.
  6. Randelli P., Cucchi D., Ragone V., Girolamo L., Cabitza P., Randelli M. History of rotator cuff surgery. Knee Surg Sports Traumatol Arthrosc. 2015;23(2):344-362. doi: 10.1007/s00167-014-3445-z.
  7. Tashjian R.Z. Epidemiology, natural history, and indications for treatment of rotator cuff tears. Clin Sports Med.2012;31(4):589-604. doi: 10.1016/j.csm.2012.07.001.
  8. Кондырев Н.М., Копенкин С.С., Скороглядов А.В. Ранняя диагностика повреждений вращающей манжеты плеча. Вестник РУДН, Серия: Медицина. 2016; (1):68-75.
  9. Grant J.A., Miller B.S., Jacobson J.A., Morag Y., Bedi A., Carpenter J.E. Intra- and 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.
  10. Roy J.S., Braen C., Leblond J., Desmeules F., Dionne C.E., Macdermid J.C. et al. Diagnostic accuracy of ultrasonography, MRI and MR arthrography in the characterization of rotator cuff disorders: a systematic review and metaanalysis. Br J Sports Med. 2015;49(20): 1316-1328. doi: 10.1136/bjsports-2014-094148.
  11. Шаях А.Б.С. МР-диагностика повреждений вращательной манжеты плечевого сустава. Радиология – практика. 2002;(1):32-35.
  12. Ellman H. Diagnosis and treatment of incomplete rotator cuff tears. Clin Orthop Relat Res. 1990;(254): 64-74.
  13. Hughes P.C., Taylor N.F., Green R.A. Most clinical tests cannot accurately diagnose rotator cuff pathology: a systematic review. Aust J Physiother.2008;54(3):159-170. doi: 10.1016/S0004-9514(08)70022-9.
  14. Jain N.B., Luz J., Higgins L.D., Dong Y., Warner J.J., Matzkin E., Katz J.N. The diagnostic accuracy of special tests for rotator cuff tear: the RoW cohort study. Am J Phys Med Rehabil. 2017;96(3):176-183. doi: 10.1097/PHM.0000000000000566.
  15. Park H.B., Yokata A., Gill H.S., el Rassi G., Mcfarland E.G. Diagnostic accuracy of clinical tests for the different degrees of subacromial impingement syndrome. J Bone Joint Surg Am.2005;87(7):1446-1455. doi: 10.2106/jBjS.D.02335.
  16. Villafañe J.H., Valdes K., Anselmi F., Pirali C., Negrini S. The diagnostic accuracy of five tests for diagnosing partial-thickness tears of the supraspinatus tendon: a cohort study. J Hand Ther. 2015;28(3):247-251; quiz 252. doi: 10.1016/j.jht.2015.01.011.
  17. Holtby R., Razmjou H. Validity of the supraspinatus test as a single clinical test in diagnosing patients with rotator cuff pathology. J Orthop Sports Phys Ther. 2004;34(4):194-200. doi: 10.2519/jospt.2004.34.4.194.
  18. 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.
  19. Burbank K.M., Stevenson J. H., Czarnecki G. R., Dorfman J. Chronic shoulder pain: Part I. evaluation and diagnosis. Am Fam Physician. 2008;77(4):453-460.0.
  20. Jesus J.O., Parker L., Frangos A.J., Nazarian L.N. Accuracy of MRI, MR arthrography, and ultrasound in the diagnosis of rotator cuff tears: a metaanalysis. AJR Am J Roentgenol. 2009;192(6):1701-1707. doi: 10.2214/ajR.08.1241.
  21. 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, часть 1):76-79. Режим доступа: https://fundamentalresearch.ru/ru/article/view?id=30042.
  22. Smith T.O., Daniell H., Geere J., Tomsc 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.
  23. Yeu K., Jiang C.C., Shih T.T. Correlation between MRI and operative findings of the rotator cuff tear. J Formos Med Assoc. 1994;93(2):134-139.
  24. Zlatkin M.B., Hoffman C., Shellock F.G. Assessment of the rotator cuff and glenoid labrum using an extremity MR system: MR results compared to surgical findings from a multi-center study. J Magn Reson Imaging. 2004;19(5):623-631. doi: 10.1002/jmri.20040.
  25. Magee T. 3-T MRI of the Shoulder: Is MR arthrography Necessary? AJR Am J Roentgenol. 2009;192(1):86-92. doi: 10.2214/ajR.08.1097.
  26. Brockmeyer M., Schmitt C., Haupert A., Kohn D., Lorbach O. Limited diagnostic accuracy of magnetic resonance imaging and clinical tests for detecting partial-thickness tears of the rotator cuff. Arch Orthop Trauma Surg. 2017;137(12):1719-1724. doi: 10.1007/s00402-017-2799-3.
  27. Jung J.Y., Jee W.H., Chun H.J., Ahn M.I., Kim Y.S. Magnetic resonance arthrography including aBeR view in diagnosing partial-thickness tears of the rotator cuff: accuracy, and inter- and intra-observer agreements. Acta Radiol. 2010;51(2):194-201. doi: 10.3109/02841850903300298.

Supplementary files

Supplementary Files
Action
1. JATS XML
Download

Copyright (c)


СМИ зарегистрировано Федеральной службой по надзору в сфере связи, информационных технологий и массовых коммуникаций (Роскомнадзор).
Регистрационный номер и дата принятия решения о регистрации СМИ: серия ПИ № ФС 77 - 82474 от 10.12.2021.


This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies