Diagnosing Shoulder Pathology: Correlating Magnetic Resonance Imaging and Arthroscopy

Abstract

Introduction: Shoulder pain is the third most common cause of musculoskeletal consultation causing significant pain and disability in performing tasks for daily living. For the diagnosis of shoulder joint pathologies, magnetic resonance imaging (MRI) and arthroscopy are commonly used. Currently arthroscopy is the gold standard in diagnosing shoulder pathologies. Also, many studies have reported MRI to be sensitive and accurate tool for investigations. The aim of the study is to compare the efficacy of MRI and arthroscopy in the diagnosis of shoulder pathologies and find the correlation between MRI and arthroscopic finding. MATERIALS AND METHODS: The prospective, comparative study was conducted between January 2020 and July 2021; patients presenting to the institute with chronic shoulder pain were included in the study after applying selection criteria. MRI followed by shoulder arthroscopy was performed for all patients, and the data were statistically analyzed. Results: Synovitis (65.9%) was the most common pathology. MRI reported high specificity (100%) for full-thickness rotator cuff tear, rotator cuff tendinitis, subacromial bursitis, and Bankart’s lesion followed by superior labrum, anterior and posterior (SLAP) lesion (96.6%), and bicep tendinitis (95.8%) while moderate specificity for synovitis (78.6%) and partial rotator cuff tear (66.7%). MRI reported to have high sensitivity for Hill–Sachs lesion, subacromial bursitis, and partial-thickness rotator cuff tear and Bankart’s lesion and low sensitivity for full-thickness rotator cuff tear, synovitis, SLAP lesions, and bicep tendinitis. MRI detected subacromial bursitis (0.807), Bankart’s lesion (0.792), and Hill–Sachs lesion (0.707) with substantial correlation whereas it detected synovitis (0.064) with only slight correlation. The accuracy of MRI was highest in diagnosing subacromial bursitis (0.90) and Bankart’s lesion (0.90) and lowest for synovitis (0.46). Conclusion: MRI is an effective technique for the diagnosis of rotator cuff tears, subacromial bursitis, synovitis, and rotator cuff tendinitis but was less effective in detecting SLAP lesions and less in differentiating the partial or complete rotator cuff tear.

Keywords

• bankart’s lesion
• magnetic resonance imaging
• rotator cuff pathology
• shoulder arthroscopy
• superior labrum
• anterior and posterior