Rotator Cuff Injury, Physical Diagnosis And Diagnostic Imaging And Arthroscopic Control Study

Objective: To evaluate the value of physical examination and imaging in the diagnosis of rotator cuff tears. Perspective study was also performed to compare the diagnostic value of different methods including routine MR, arthrograp, and MRAMaterials and Methods: Seventy consecutive patients with suspected rotator cuff tears were examined with physical examination, X-ray arthrography ,routine MR, arthrography, and MR arthrography before the of the examination of .shoudler arthroscope. Base on the results of the arthrography, the diagnostic sensitivity, specificity, and accuracy of the physical examination, and the diagnostic value of routine MR, arthrography, and MR arthrography were compared. The advantages and disadvantages of every method were also discussed.Results: The 35 cases included 18 full-thickness tears, 11 Partial thickness tears and 6 non-tears. Based on the shoudler arthroscope accuracy of physical examination were83%. For the diagnosis rotator cuff tears the sensitivity, specificity, and accuracy were 78%, 80%, and 81% of the routine MR. respectively ;the figures were 94%,93%,and 93% of the X-ray arthrography. respectively ;while the date were 100%, 95%, and 97% for MRA. for the diagnosis full-thickness tears the sensitivity, specificity, and accuracy were 83%, 86%, and 81% of the routine MR ;respectively ;the figures were 91%, 93%, and 86% of the X-ray arthrography, respectively ;while the date were 100%, 100%, and 100% for MRAConclusion: physical examination is a good modality in the diagnosis of rotator cuff tears. The routine MR is a relatively accurate method for revealing rotator cuff tears. The accuracy of arthrography for rotator cuf tears is higher than that of routine MR. MRA is the most accurate method among these three diagnostic imaging methods.