The Journal of Bone and Joint Surgery, Vol 76, Issue 3 335-340, Copyright © 1994 by Journal of Bone and Joint Surgery, Inc
Ultrasonography and arthrography in the diagnosis of tears of the rotator cuff
P Paavolainen and J Ahovuo
Division of Orthopaedic Surgery, University of Helsinki, Finland.
The accuracy of ultrasonography and arthrography in the prediction of
lesions of the rotator cuff was evaluated and compared with the operative
findings in a retrospective study of forty-nine patients (forty-nine
shoulders). In the detection of full-thickness (stage-III) tears of the
rotator cuff, ultrasonography had an over-all sensitivity of 74 per cent, a
specificity of 95 per cent, an accuracy of 84 per cent, a predictive value
of a positive test of 95 per cent, and a predictive value of a negative
test of 75 per cent. In contrast, arthrography demonstrated a sensitivity
of 93 per cent, a specificity of 95 per cent, an accuracy of 94 per cent, a
predictive value of a positive test of 96 per cent, and a predictive value
of a negative test of 91 per cent. Ultrasonography could not reliably
differentiate between partial (stage-II) and full-thickness (stage-III)
tears. Lesions of the long head of the biceps brachii tendon were recorded
by ultrasonography for twenty-two patients (45 per cent) and by
arthrography for eleven patients (22 per cent). The ultrasonographic
finding of fluid in the sheath of this tendon is not a reliable sign of a
lesion in the tendon.
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