Rotator cuff tears are very common, and their incidence rate increases with age. Shoulder ultrasonography seems to have recently gained popularity for detecting these types of fractures, essentially because of the efficiency, cost-effectiveness, time-saving and real-time nature of this procedure.
A study recently published on BioMed Central gives us a detailed account about the methods they used for their research on this topic. The patients submitted to this study were retrospectively reviewed from January 2007 to December 2012 and divided into 2 groups – the Ultrasound (-) group and the Ultrasound (+) group. The data of both groups was compared on the following terms:
- Wait time from outpatient department (OPD) visit to MRI exam;
- MRI exam to operation (OP);
- OPD visit to OP;
- Patient’s number for MRI exam;
- Number of patients who finally had rotator cuff repair within two groups.
But first, let’s go back in time…
Rotator cuff tears are a common cause of reduced shoulder function and debilitating pain and weakness. Data tells us that around 40% of patients older than 60 years are affected by this condition and it can be encountered in about 50% of patients over 70 years old.
This condition is left untreated most of the times, with the patient expecting it to spontaneously heal itself.
At the start of the study, 50 subjects were found with an asymptomatic rotator cuff tear, out of which “18 developed symptoms at a mean time of 18 months”. Usually, when a patient is presented with a rotator cuff tear and a concomitant stiff shoulder, the stiffness is first treated in a non-operative way until the shoulder regains passive range of motion (ROM) and then surgery for rotator cuff repair is later performed.
You may need to pay some extra attention to patients with diabetes because the rotator cuff tear may extend during the treatment of the stiffness. To stop this problem, some recent studies suggest simultaneous treatment of the rotator cuff tear and stiffness.
For detecting rotator cuff tears, MRI are commonly used in clinical practice, but that method is outdated and costly. Shoulder ultrasonography performed by a technician and interpreted by a radiologist with expertise has been shown to be accurate in detecting full-thickness and partial-thickness tears of the rotator cuff.
The sensitivity and accuracy of ultrasonography ranges from 91 to 100% and 85 to 86%, respectively. This technique can also provide bilateral information without being affected by the presence of intra-osseous hardware. It is better tolerated by patients and it allows them to view real-time information and results. It is also less expensive than MRI.
Going back to the present…
Since shoulder ultrasonography confirms the integrity of the rotator cuff tears, orthopedic surgeons and patients can be more confident of achieving successful results with non-operative treatment using this method.
If surgical treatment is the only option, the PeekMed software might be exactly what you’re looking for. In order to give you an overview of the procedures that need to be done in the surgery, PeekMed offers you the possibility to visualize them in PeekMed: 2D, 3D and hybrid environment.
Shoulder ultrasound examination can be used along with the patient’s clinical history and physical examination. It provides precious information regarding the state of the rotator cuff and the wait time can be reduced from first outpatient visit to final surgery and from MRI to final surgery.