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The Journal of Bone and Joint Surgery, Vol 73, Issue 1 17-29, Copyright © 1991 by Journal of Bone and Joint Surgery, Inc
Magnetic resonance imaging of the shoulder. Sensitivity, specificity, and predictive value
JP Iannotti, MB Zlatkin, JL Esterhai, HY Kressel, MK Dalinka and KP Spindler
Department of Orthopaedic Surgery, University of Pennsylvania, School of Medicine, Philadelphia 19104.
The sensitivity, specificity, and predictive value of magnetic resonance
imaging in the diagnosis of lesions of the rotator cuff, glenohumeral
capsule, and glenoid labrum were evaluated in ninety-one patients and
fifteen asymptomatic volunteers. Magnetic resonance imaging demonstrated
100 per cent sensitivity and 95 per cent specificity in the diagnosis of
complete tears, and it consistently predicted the size of the tear of the
rotator cuff. There was a definite correlation between atrophy of the
supraspinatus muscle and the size of a complete, chronic tear of the
rotator cuff. The sensitivity and specificity of magnetic resonance imaging
in the differentiation of tendinitis from degeneration of the cuff were 82
and 85 per cent, and in the differentiation of a normal tendon from one
affected by tendinitis with signs of impingement the sensitivity and
specificity were 93 and 87 per cent. The formation of spurs around the
acromion and acromiocalvicular joint correlated highly with increased age
of the patient and with chronic disease of the rotator cuff. The
sensitivity and specificity of magnetic resonance imaging in the diagnosis
of labral tears associated with glenohumeral instability were 88 and 93 per
cent. The study showed that high-resolution magnetic-resonance imaging is
an excellent non-invasive tool in the diagnosis of lesions of the rotator
cuff and glenohumeral instability.
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