TO STUDY THE COMPARATIVE EFFICACY OF ULTRASOUND VIS A VIS MRI IN SHOULDER PATHOLOGIES

Background and Aims: The shoulder joint, characterized by its wide range of motion, is prone to a variety of pathologies due to its inherent compromise between stability and mobility. While MRI is considered the gold standard for evaluating shoulder pathologies, its limitations, including cost and accessibility, underscore the need for alternative diagnostic modalities like ultrasound (USG). This study aims to compare the diagnostic efficacy of USG and MRI in evaluating shoulder pathologies, with a focus on rotator cuff abnormalities. Methods: This single-center, prospective study was conducted in the Department of Radiodiagnosis at Chhatrapati Shivaji Subharti Hospital, Meerut, over 1 year and 9 months. After obtaining ethical approval, 120 patients with clinical suspicion of shoulder pathologies were recruited. Patients underwent USG using a Samsung HS70A machine and MRI using a uMR 780 3.0T scanner with standardized imaging protocols. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and diagnostic accuracy were calculated for both modalities. Statistical analysis was performed using IBM SPSS Version 25. Results: USG demonstrated high sensitivity, specificity, and accuracy in detecting full-thickness and partial-thickness rotator cuff tears, with comparable performance to MRI in diagnosing calcific tendinosis and subacromial impingement. However, MRI outperformed USG in characterizing tear extent, evaluating labral pathologies, and detecting minimal joint effusions. Non-rotator cuff pathologies, including ACJ arthropathy, bursitis, and biceps tendon disorders, were reliably identified by USG with high specificity, consistent with previous literature. Conclusion: Ultrasound is a reliable, cost-effective diagnostic tool for shoulder pathologies, particularly for rotator cuff tears and dynamic evaluations, making it an excellent preliminary modality. MRI remains indispensable for detailed anatomical characterization and subtle pathologies, complementing USG for comprehensive shoulder assessments.