Exploring The Ability Of Diagnosing Rotator Cuff Tears Based On Nonstandard Anteroposterior Radiographs

Objective: To evaluate the ability of non-standard anteroposterior(AP)radiographs to diagnose rotator cuff tears,and explore diagnostic methods with better diagnostic authenticity and reliability in non-standard radiographs.Methods: In this retrospective study,according to inclusion and exclusion criteria,patients,who underwent AP radiographs and MRI of the ipsilateral shoulder joint in Sichuan Province Orthopedic Hospital,would be selected.Patients were divided into rotator cuff tear group and non-rotator cuff tear group based on MRI diagnose.Three researchers measured the AP radiographs :acromiohumeral interval(AHI),upward migration index(UMI),acromial index(AI),critical shoulder angle(CSA),lateral acromion angle(LAA),double-circle radius ratio(DRR),and superior humeral excursion(SHE).Evaluate the diagnostic value of these methods in identifying rotator cuff tears on non-standard AP radiographs.Results: Diagnostic reliability analysis showed that the intra-group correlation coefficients(ICC)of AHI,UMI,AI,CSA,LAA and DRR SHE were 0.738,0.670,0.858,0.874,0.707,0.781 and 0.515,respectively.Differences were only found in AHI and UMI of one surveyor in patients with non-rotator cuff tears compared with rotator cuff tears(p=0.037,0.021).Receiver operating characteristic(ROC)curves showed no diagnostic value when each diagnostic method independently diagnosed rotator cuff tear(p>0.05).The area under curve(AUC)of UMI and CSA combined diagnosis was higher than that of independent diagnosis,but had no diagnostic significance(p>0.05).The diagnosis value of rotator cuff tear was found in only one surveyor,with the AUC of 0.761(p=0.042)and sensitivity and specificity of 0.833 and0.622,respectively.Conclusion: Our research shows that all diagnostic methods except SHE have good reliability,even when used in non-standard AP radiographs.Unfortunately,none of the above diagnostic methods found diagnose value of rotator cuff tears based on non-standard AP radiographs.Based on this study,showing that non-standard AP radiographs can adversely affect the diagnosis of rotator cuff tears,we recommend that plain radiographs meet standard AP radiographs before using those radiological diagnostic method to diagnose rotator cuff tears.The combined diagnosis of UMI and CSA showed a tendency to improve the diagnostic accuracy in non-standard AP radiographs.This indicates that combined diagnosis in non-standard AP radiographs has the potential to improve diagnostic capability and possibly eliminate the influence of measurement errors in non-standard AP radiographs.