The use of shoulder ultrasound in a one-stop clinic: diagnostic accuracy for rotator cuff tear and biceps tendon pathology


Paul Cowling, Department of Trauma and Orthopaedics, James Cook University Hospital, Marton Road, Middlesbrough TS4 3BW, UK.
Tel.: +44 (0)1642 854380.
Fax: +44 (0)1642 854375.


Background Ultrasonography is useful in diagnosing rotator cuff tears in one-stop shoulder clinics. The present study aimed to investigate one-stop shoulder clinic ultrasonographic accuracy when diagnosing rotator cuff tears and their size, as well as long head of biceps (LHB) tendon pathology.

Methods One hundred and twenty-two patients who underwent shoulder arthroscopy following pre-operative ultrasonography in a one-stop shoulder clinic were analyzed retrospectively.

Results Partial thickness cuff tears were detected with a sensitivity and specificity of 65.0% and 94.0%, respectively, and full thickness tears at 94.8% and 93.8%, respectively. Full thickness tears were further analyzed as small tears, (<1 cm), with a sensitivity and specificity of 50.0% and 96.6%, respectively; moderate (1 cm to 3 cm), at 88.5% and 93.8%, respectively; and large/massive tears (>3 cm) at 73.1% and 99.0%, respectively.

LHB pathology diagnosis sensitivity and specificity was 62.5% and 100%. Further analysis revealed a sensitivity and specificity of LHB dislocation of 83.3% and 100%, respectively, and rupture of 61.1% and 99.0%, respectively.

Conclusions This is the first study to report shoulder ultrasonographic accuracy at a one-stop clinic when investigating cuff tear size and LHB pathology. Ultrasonography at a one-stop clinic is a cost-effective accurate method of managing patients with shoulder pathology.