Journals / Acta Orthopaedica et Traumatologica Turcica / 2020 / Cilt: 54 - Sayı: 4

Diagnostic accuracy of ultrasound in subscapularis tendon abnormalities and the importance of operator experience

Pages
423–429
DOI
—
🏛️Bibliographic metadata and full text access for this article are provided via DergiPark.
DergiPark Record ↗
✨

AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

The differentiation between tendinosis andPT tear is difficult (more prominent in less experienced user); however, because this would not change the treatment choice,shoulder US is recommended after basic training in subscapularis pathologies.

📌 3 Key Takeaways

🎯
Objective & Hypothesis:Objective: This study aimed to investigate the reasons behind the compliance, diagnostic success, and failure of ultrasound(US) examinations of two radiologists with reference to magnetic resonance imaging (MRI) in the abnormalities of subscapularis (SSC) tendon, including tendinosis.Methods: One less experienced radiologist (operator-1) and one senior radiologist, experienced in the musculoskeletal US(operator-2), performed the shoulder US on 78 patients (mean age: 53.18±10.89 [22-73] years), who had undergone MRI forroutine reasons except malignancy, within 1-4 weeks of MRI.
📊
Key Findings & Data:The thickness of the anterior and lateral soft tissues in the shoulder girdle was measured by MRI.The inter-operator agreement on the US results, the US-MRI compliance for each operator, and the relationship between theUS-MRI compliance and tissue thickness were investigated.Results: The inter-operator agreement on the US findings was moderate.
💡
Conclusion & Impact:The differentiation between tendinosis andPT tear is difficult (more prominent in less experienced user); however, because this would not change the treatment choice,shoulder US is recommended after basic training in subscapularis pathologies.
🔬Design:Research Article
📍Scope:Comprehensive Sample
⚙️Variables:Domain Parameters

Özet

Objective: This study aimed to investigate the reasons behind the compliance, diagnostic success, and failure of ultrasound(US) examinations of two radiologists with reference to magnetic resonance imaging (MRI) in the abnormalities of subscapularis (SSC) tendon, including tendinosis.Methods: One less experienced radiologist (operator-1) and one senior radiologist, experienced in the musculoskeletal US(operator-2), performed the shoulder US on 78 patients (mean age: 53.18±10.89 [22-73] years), who had undergone MRI forroutine reasons except malignancy, within 1-4 weeks of MRI. Tendinopathy, partial (PT), or full-thickness (FT) tears wererecorded in the subscapularis. The thickness of the anterior and lateral soft tissues in the shoulder girdle was measured by MRI.The inter-operator agreement on the US results, the US-MRI compliance for each operator, and the relationship between theUS-MRI compliance and tissue thickness were investigated.Results: The inter-operator agreement on the US findings was moderate. The US-MRI compliance was fair for operator-1, butsubstantial for operator-2. The circumferential soft tissue thickness and US-MRI compliance were not correlated (p>0.05).The interobserver agreement in US was moderate (K: 0.415). The US-MRI compliance was fair for operator-1 (K: 0.344) andsubstantial for operator-2 (K: 0.616). The accuracy rates for the differentiation of normal tendon, tendinosis, PT, and FT were59%, 75%, 72%, and 100%, respectively, for operator-1 and 87%, 83%, 85%, and 100%, respectively, for operator-2. However,the respective sensitivity of operator-1 was 46%, 19%, 44%, and 100%; and operator-2 was 91%, 67%, 82%, and 100%. Thediagnostic performance of operator-1 was lower, except for FT.Conclusion: The thickness of the surrounding tissue does not affect the US results. The differentiation between tendinosis andPT tear is difficult (more prominent in less experienced user); however, because this would not change the treatment choice,shoulder US is recommended after basic training in subscapularis pathologies.

🔖

Cite This Article

TOPRAK, U., TÜRKOĞLU, S., AYDOĞAN, Ç., KOVALAK, E., SAYLISOY, S., SIDDIKOĞLU, D., MAHMUD, A. (2020). Diagnostic accuracy of ultrasound in subscapularis tendon abnormalities and the importance of operator experience. Acta Orthopaedica et Traumatologica Turcica, Cilt: 54 - Sayı: 4, 423–429. https://ajindex.com/articles/353487

References (14)

  1. Lo IKY, Burkhart SS. Subscapularis tears: arthroscopic repair of the forgotten rotator cuff tendon. Tech Shoulder Elbow Surg 2002
  2. [Crossref] 2. Malavolta EA, Assunção JH, Guglielmetti CL, et al. Accuracy of preoperative MRI in the diagnosis of subscapularis tears. Arch Orthop Trauma Surg 2016
  3. [Crossref] 3. Naimark M, Zhang AL, Leon I, Trivellas A, Feeley BT, Ma CB. Clinical, radiographic, and surgical presentation of subscapularis tendon tears: a retrospective analysis of 139 Patients. Arthroscopy 2016
  4. [Crossref] 4. Park JY, Chung SW, Lee SJ, et al. Combined subscapularis tears in massive posterosuperior rotator cuff tears: Do they affect postoperative shoulder function and rotator cuff integrity? Am J Sports Med 2016
  5. [Crossref] 5. Li XX, Schweitzer ME, Bifano JA, Lerman J, Manton GL, ElNoueam KI. MR evaluation of subscapularis tears. J Comput Assist Tomogr 1999
  6. [Crossref] 6. Morag Y, Jamadar DA, Miller B, Dong Q, Jacobson JA. The subscapularis: anatomy, injury, and imaging. Skeletal Radiol 2011
  7. [Crossref] 7. Arai R, Nimura A, Yamaguchi K, et al. The anatomy of the coracohumeral ligament and its relation to the subscapularis muscle. J Shoulder Elbow Surg 2014
  8. [Crossref] 8. Flury MP, John M, Goldhahn J, Schwyzer HK, Simmen BR. Rupture of the subscapularis tendon (isolated or in combination with supraspinatus tear): When is a repair indicated? J Shoulder Elbow Surg 2006
  9. [Crossref] 9. Wright JM, Heavrin B, Hawkins RJ, Noonan T. Arthroscopic visualization of the subscapularis tendon. Arthroscopy 2001
  10. [Crossref] 10. Narasimhan R, Shamse K, Nash C, Dhingra D, Kennedy S. Prevalence of subscapularis tears and accuracy of shoulder ultrasound in pre-operative diagnosis. Int Orthop 2016
  11. [Crossref] 11. Teefey SA, Rubin DA, Middleton WD, Hildebolt CF, Leibold RA, Yamaguchi K. Detection and quantification of rotator cuff tears. Comparison of ultrasonographic, magnetic resonance imaging, and arthroscopic findings in seventy-one consecutive cases. J Bone Joint Surg Am 2004
  12. A: 708-16. [Crossref] 12. Teefey SA, Middleton WD, Payne WT, Yamaguchi N. Detection and measurement of rotator cuff tears with sonography: analysis of diagnostic errors. AJR Am J Roentgenol 2005
  13. [Crossref] 13. Landis, JR, Koch GG. The measurement of observer agreement for categorical data. Biometrics 1977
  14. [Crossref] 14. Alilet M, Behr J, Nue