Rotator Cuff Tendinopathy; Comparison Between Conventional Sonography, Sonoelastography, and MRI in Healthy Volunteers and Patients with Shoulder Pain

Abstract

AIM OF THE WORK: To evaluate the value of sonoelastohraphy in rotator cuff tendinopathy. METHODS & MATERILS: Rotator cuff tendons of 40 patients with shoulder pain, patients with complete rotator cuff tear were excluded, 22 men, 18 women; mean age, 47.9 years and 40 healthy volunteers (22 men, 18 women; mean age, 39.8 years were examined by US, and SEL,&MRI. The MRI findings of tendinopathy were used as reference golden standard and were compared to US and SEL findings. By using US intratendinous focal areas of abnormal echogenicity were defined as pathologic. SE images were evaluated using color mapping grading system representing stiff tissue (blue) to more soft tissue (green, yellow, red). RESULTS: In healthy volunteers, SEL of rotator cuff tendons showed mainly blue color with areas of green coloring and normal findings on US scale & T2 MR images. No red or yellow coloring was detected, interpreted as sign for harder tissue characteristics. In patients with shoulder pain showed typical signs of rotator cuff tendinopathy in MRI, 34/40 showed signs of tendinopathy by US while 38/40 showed signs of tendinopathy using SEL. In details, US showed a sensitivity of 85% and specificity of 95% while SEL showed a sensitivity of 95%, specificity of 100%. ROC analysis showed a SEL cut off value of strain ration < 5.4 has a sensitivity of 97.5% & specificity of 100%. CONCLUSIONS: qualitative and quantitative SEL showed improved the sensitivity and specificity in the detection of rotator cuff tendinopathy to the conventional US.