Arthroscintigraphy in suspected rotator cuff rupture

Aim: In order to evaluate the diagnostic efficiency of arthroscintigraphy i n suspected rotator cuff ruptures this new imaging procedure was performed 20 times in 17 patients with clinical signs of a rotator cuff lesion. The s cintigraphic results were compared with sonography (n = 20), contrast arthr ography (n = 20) and arthroscopy (n = 10) of the shoulder joint. Methods: A fter performing a standard bone scintigraphy with intravenous application o f 300 MBq 99m-Tc-methylene diphosphonate (MDP) for landmarking of the shoul der region arthroscintigraphy was performed after an intraarticular injecti on of 99m-Tc microcolloid (ALBURES 400 mu Ci/5 mi). The application was per formed either in direct combination with contrast arthrography (n = 10) or ultrasound conducted mixed with a local anesthetic (n = 10). Findings at ar throscopical surgery (n = 10) were used as the gold standard. Results: In c ase of complete rotator cuff rupture (n = 5), arthroscintigraphy and radiog raphic arthrography were identical in 5/5. In one patient with advanced deg enerative alterations of the shoulder joint radiographic arthrography incor rectly showed a complete rupture which was not seen by arthroscintigraphy a nd endoscopy. In 3 patients with incomplete rupture, 2/3 results were consi stant. A difference was seen in one patient with a rotator cuff, that has b een already revised in the past and that suffered of capsulitis and calcifi cation. Conclusion: Arthroscintigraphy is a sensitive technique for detecti on of rotator cuff ruptures. Because of the lower viscosity of the active c ompound, small ruptures can be easily detected, offering additional value o ver radiographic arthrography and ultrasound, especially for evaluation of incomplete cuff ruptures.