A comparative study of ultrasonography with magnetic resonance imaging in patients with painful shoulder

The recent improvement of musculoskeletal imaging achieved by high-frequenc y ultrasonography (US) and its important advantages as a routine dynamic im aging tool-providing results rapidly, absence of secondary effects, and low cost-make US a very useful tool in rheumatologic practice. We prospectivel y compared high-frequency US with magnetic resonance imaging (MRI) in patie nts with painful shoulder syndrome. Thirty-four consecutive patients (36 shoulders) with a first flare of shoul der pain were included in the study. US and MRI shoulder examination were p erformed within 2 weeks. US shoulder examinations were performed by a rheum atologist experienced in US, without knowledge of the MRI results. The MRT results were considered the gold standard. US showed high sensitivity, spec ificity, and positive and negative predictive values (range 85.7%-100%) in the diagnosis of tendinitis, partial-thickness, and full-thickness tear of the rotator cuff and degenerative changes of the acromio-clavicular joint. Rotator cuff calcifications were detected only by US. We highly recommend t hat for many painful shoulders, appropriately trained rheumatologists tan p erform US examinations to establish an accurate diagnosis and, thereby, imp rove therapy.