Investigations

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Orthopaedics

Rotator cuff tears

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calcification where the cuff inserts on the greater tuberosity is commonly seen in chronic tendinitis

erosion of the acromium process and a high riding humeral head may be seen in a long standing tear

osteoarthritis of the acromioclavicular joint - common finding in older patients



MRI - effective for visualising inflammation and tears (2)

arthroscopy - permits diagnosis and treatment

If available, magnetic resonance arthrography has been found to be more sensitive and specific than MRI and ultrasound (which are equivalent) in the diagnosis of rotator cuff tears.​(2)

Expert Panel on Musculoskeletal Imaging; Small KM, Adler RS, Shah SH, et al. ACR appropriateness criteria: shoulder pain - atraumatic. J Am Coll Radiol. 2018 Nov;15(11s):S388-402.

de Jesus JO, Parker L, Frangos AJ, et al. Accuracy of MRI, MR arthrography, and ultrasound in the diagnosis of rotator cuff tears: a meta-analysis. AJR Am J Roentgenol. 2009 Jun;192(6):1701-7.

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	Sensitivity (%)	Specificity (%)
Clinical Examination	90	50
Ultrasound	85	92
Magnetic resonance imaging	86	90
Magnetic resonance arthrography	92	97

Investigations

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