Efficacy of Ultrasound to Detect Rotator Cuff Tears

Introduction: Rotator cuff injury is the most common cause of shoulder pain in the world, and there are a few different imaging techniques that can be used to help with their diagnosis. The purpose of this review is to determine the efficacy of ultrasound, an available and cost-effective option, to detect rotator cuff tears. Methods: PubMed was searched for studies and meta-analyses that compared ultrasound to other imaging modalities and their ability to detect rotator cuff tears. Results: One meta-analysis and 4 clinical research studies revealed that ultrasound has variable diagnostic accuracy compared to MRI depending on the RCT tendon, size, obesity, shoulder ROM, and operator experience. Ultrasound had 87-94% sensitivity and 88-100% specificity for unspecified FT RCTs, and 53-62% sensitivity and 85-97% specificity for unspecified PT RCTs. Two of the studies included showed a 100% specificity for FT RCTs. In most studies, US had better specificity for diagnosis of RCT than sensitivity, but this was not consistent through all studies reviewed. Discussion: Ultrasound is a viable initial imaging modality to aid in the diagnosis of rotator cuff tears but should not be used in exchange of MRI, especially in the cases of obesity or decreased shoulder range of motion.