Site and size of rotator-cuff tear - Findings at ultrasound, double-contrast arthrography, and computed tomography arthrography with surgical correlation

RATIONALE AND OBJECTIVES. The authors discuss findings of ultrasound (US), double-contrast arthrography (AG), and contrast computed tomography arthrography (CTA) in assessing precise site and size of rotator-cuff tears. METHODS. Eighty-Six patients were compared prospectively in a masked fashion; the results of surgery were studied in 25 patients and the results of arthroscopy were studied in 61 patients, RESULTS. Ultrasound detected 80% (8 of 10) of the partial-thickness tears and 90% (18 of 20) of the full-thickness tears, Arthrography and CTA had identical results with 70% sensitivity (7 of 10) in partial-thickness tears; AG showed 90% (18 of 20) and CTA 95% (19 of 20) of the full-thickness tears. Arthrography had two false-positive findings, and US and CTA had one each, The size of a tear could be evaluated correctly with AG in 30% (9 of 30), with US in 70% (21 of 30) and with CTA in 76% (23 of 30). More extensive tears were encountered at US than had been found at surgery in 2% (2 of 86) and less extensive tears in 9% (8 of 86); CTA depicted more extensive tears in 2% (2 of 86) and less extensive tears in 6% (6 of 86), respectively. The site of a tear could be evaluated with AG in 30% (9 of 30); US and CTA showed the site correctly in every patient in which the tear could be diagnosed. CONCLUSION. Ultrasound and CTA were equally accurate in diagnosing and evaluating the size and site of rotator-cuff tears, Double-contrast AG was less accurate in the diagnosis of tears and the size and site of tears clearly could be assessed worse.