BACKGROUND: A number of radiographic signs have been previously demonstrated to be associated with degenerative rotator cuff tears. An ability to predict the presence of a tear by radiography would permit the early commencement of appropriate treatment and the avoidance of unnecessary invasive investigations. The aim of the present study was to determine the accuracy of using radiographic signs to predict the presence of a cuff tear on arthroscopy. METHODS: Fifty consecutive patients who had undergone shoulder arthroscopy and had pre-operative plain radiographs were included. Pre-operative radiographs were reviewed by a consultant shoulder surgeon, a consultant radiologist and a senior clinical fellow for the following signs: acromial spur; subjective reduction of subacromial space; sourcil sign; acromial acetabularization; os acromiale; greater tuberosity cortical irregularity; greater tuberosity sclerosis; humeral head rounding; cyst; and reduction in acromiohumeral head distance. RESULTS: The presence of tuberosity sclerosis (p < 0.0001), tuberosity irregularities (p < 0.0001), tuberosity cyst (p = 0.004) and sourcil sign (p = 0.019) was associated with the presence of a rotator cuff tear. The combined sensitivity of prediction of tear by the observers following radiographic review was 91.7%, with a combined negative predictive value of 80%. CONCLUSIONS: The assessment of radiographs by senior clinicians is a useful tool for confirming the absence of a rotator cuff tear.
BACKGROUND: A number of radiographic signs have been previously demonstrated to be associated with degenerative rotator cuff tears. An ability to predict the presence of a tear by radiography would permit the early commencement of appropriate treatment and the avoidance of unnecessary invasive investigations. The aim of the present study was to determine the accuracy of using radiographic signs to predict the presence of a cuff tear on arthroscopy. METHODS: Fifty consecutive patients who had undergone shoulder arthroscopy and had pre-operative plain radiographs were included. Pre-operative radiographs were reviewed by a consultant shoulder surgeon, a consultant radiologist and a senior clinical fellow for the following signs: acromial spur; subjective reduction of subacromial space; sourcil sign; acromial acetabularization; os acromiale; greater tuberosity cortical irregularity; greater tuberosity sclerosis; humeral head rounding; cyst; and reduction in acromiohumeral head distance. RESULTS: The presence of tuberosity sclerosis (p < 0.0001), tuberosity irregularities (p < 0.0001), tuberosity cyst (p = 0.004) and sourcil sign (p = 0.019) was associated with the presence of a rotator cuff tear. The combined sensitivity of prediction of tear by the observers following radiographic review was 91.7%, with a combined negative predictive value of 80%. CONCLUSIONS: The assessment of radiographs by senior clinicians is a useful tool for confirming the absence of a rotator cuff tear.
Authors: Albert W Pearsall; Shawn Bonsell; R J Heitman; Clyde A Helms; Daryl Osbahr; Kevin P Speer Journal: J Shoulder Elbow Surg Date: 2003 Mar-Apr Impact factor: 3.019
Authors: Jon A Jacobson; Scott Lancaster; Amitesh Prasad; Marnix T van Holsbeeck; Josesph G Craig; Patricia Kolowich Journal: Radiology Date: 2004-01 Impact factor: 11.105
Authors: D Goutallier; P Le Guilloux; J-M Postel; C Radier; J Bernageau; S Zilber Journal: Orthop Traumatol Surg Res Date: 2011-04-01 Impact factor: 2.256
Authors: Nadja Saupe; Christian W A Pfirrmann; Marius R Schmid; Bernhard Jost; Clément M L Werner; Marco Zanetti Journal: AJR Am J Roentgenol Date: 2006-08 Impact factor: 3.959