Detection and Measurement of Rotator Cuff Tears with Sonography: Analysis of Diagnostic Errors
Sharlene A. Teefey1,
William D. Middleton1,
William T. Payne2 and
Ken Yamaguchi3
1 Mallinckrodt Institute of Radiology, Washington University School of Medicine,
510 S Kingshighway Blvd., St. Louis, MO 63110.
2 Department of Orthopaedics and Rehabilitation, Southern Illinois University
School of Medicine, Springfield, IL 62794.
3 Department of Orthopaedic Surgery, One Barnes-Jewish Hospital Plaza, St.
Louis, MO 63110.
View larger version (102K):
[in a new window]
|
Fig. 1A. —45 year-old woman with an articular-side, partial-thickness
tear. Longitudinal sonographic image shows a normal, intact cuff.
|
|
View larger version (102K):
[in a new window]
|
Fig. 1B. —45 year-old woman with an articular-side, partial-thickness
tear. Transverse sonographic image shows a normal, intact cuff. The small tear
was missed. It measured 5 (length) x 15 (width) mm at surgery. BT =
biceps tendon.
|
|
View larger version (125K):
[in a new window]
|
Fig. 2. —75-year-old man with an extensive bursal-side tear involving
greater than 90% of the cuff. Longitudinal image shows a 1-cm tear
(cursors) surrounded by fluid with a few intact articular-side fibers
that was interpreted as full-thickness tear on the sonogram. Tear was detected
but misinterpreted due to inherent limitations of the test.
|
|
View larger version (83K):
[in a new window]
|
Fig. 3. —78-year-old woman with a markedly thinned, extensive
partial-thickness tear involving almost the entire rotator cuff. Longitudinal
image shows flattening of the cuff and loss of cuff substance
(cursors) that was interpreted as a full-thickness tear on the
sonogram. The tear was detected but misinterpreted due to the inherent
limitations of the test.
|
|
View larger version (111K):
[in a new window]
|
Fig. 4. —43-year-old woman with a full-thickness rotator cuff tear
involving the supraspinatus and infraspinatus tendons extending over the
rotator interval but not involving the subscapularis tendon. The longitudinal
image of the subscapularis tendon shows defect (cursors) that was
misinterpreted as a full-thickness tear on the sonogram.
|
|
View larger version (110K):
[in a new window]
|
Fig. 5. —64-year-old man with adhesive capsulitis and an intact cuff.
The longitudinal image shows contour deformity (cursors) of the
supraspinatus tendon that was interpreted as a full-thickness tear on the
sonogram. The reason for the error could not be determined.
|
|
View larger version (121K):
[in a new window]
|
Fig. 6. —67-year-old woman with an articular-side, partial-thickness
supraspinatus tear. Transverse image shows the original measurement of the
tear width (cursors), which was underestimated. The more likely tear
width (arrows) correlates with the arthroscopic measurement of 15 mm.
BT = biceps tendon.
|
|
CiteULike 
Complore 
Connotea 
Del.icio.us 
Digg 
Reddit 
Technorati What's this?
Copyright © 2005 by the American Roentgen Ray Society.
