The most common cause of shoulder pain is rotator cuff pathology and most common finding in shoulder instability is labral tears, hence these two are the most common abnormalities detected in MRI shoulder and the common indication of arthroscopic intervention. MRI has decisive role in planning the treatment for patients. Hence analysing the accuracy and pitfalls of MRI in diagnosing rotator cuff and labral tears in comparison with arthroscopy, which is the gold standard tool is necessary.
Aim: To compare the MRI shoulder accuracy with arthroscopy, as the gold standard in detecting rotator cuff and labral pathologies of shoulder.
Materials and Methods: Prospective study of forty consecutive patients with chronic shoulder pain and instability presented to out patient clinic of orthopaedics department of our hospital with clinical signs of rotator cuff tear, impingement and instability, who had undergone MRI of the shoulder joint followed by arthroscopic intervention. The MRI results were compared with arthroscopy findings for evaluation of diagnostic accuracy.
Results: Out of 40 patients, supraspinatus tendon tear was the commonest pathology detected and next common was the Bankart’s labral tear. MRI showed 100% sensitivity in the diagnosis of complete thickness supraspinarus and subscapularis tears and bankart’s lesion but had poor sensitivity of 60% to detect SLAP tear. The accuracy of MRI in detecting rotator cuff tear and labral tears were comparable.
Conclusion: MRI is highly sensitive in diagnosing rotator cuff tears and Bankart’s tear but was not sensitive in diagnosing SLAP tears. Radiologist needs to understand the pitfalls of MRI while evaluating the MRI shoulder for higher accuracy.