DIAGNOSIS OF ROTATOR CUFF TEARS: A COMPARISON BETWEEN CLINICAL EXAMINATION, MRI AND OPERATIVE FINDINGS. OUR EXPERIENCE IN A DISTRICT GENERAL HOSPITAL.

Abstract

Introduction: Diagnosis of rotator cuff tears by clinical examination and MRI is not always accurate. If the extent of the tear could be predicted pre-operatively, both the patient and the surgeon would be better equipped for the subsequent operation and rehabilitation.

Aim: To assess the accuracy of clinical examination and MRI in detecting the presence of rotator cuff tears.

Method and Results: Retrospective analysis of 86 patients with symptoms and signs of rotator cuff disease. All underwent clinical examination of the shoulder followed by an MRI scan. The diagnosis was confirmed intra-operatively.

Sensitivity of clinical examination for all tears was 69%, with a specificity of 64% and a positive predictive value of 80%. Individual sensitivities were as follows: grade I 50%, II 76%, III 100%. MRI had a sensitivity of 82.8% for all tears, specificity of 57% and a positive predictive value of 80%. Individual sensitivities: I 69%, II 90%, III 100%.

Conclusion: In some patients clinical examination remains uncertain, MRI is helpful but the diagnosis is not always reliable.