Assessment of the Diagnostic Accuracy of Ultrasonography for the Detection of Rotator Cuff Tear with Respect to Magnetic Resonance Imaging

Introduction: Shoulder pain is a prevalent musculoskeletal complaint, and accurate imaging is essential for diagnosing underlying structural abnormalities. Ultrasonography (USG) is widely used as a first-line modality due to its accessibility and cost-effectiveness, while magnetic resonance imaging (MRI) remains the reference standard. This study evaluates the diagnostic performance of USG compared with MRI across multiple shoulder pathologies. Aims and Objectives: To assess the accuracy of USG in detecting shoulder abnormalities— including rotator cuff tears, tendinopathy, bursitis, and arthritis—using MRI as the gold standard. Materials and Methods: Seventy participants underwent detailed clinical evaluation followed by USG and MRI of the affected shoulder. Demographic characteristics, handedness, occupational profile, comorbidities, and laterality were documented. USG findings were compared with MRI for partial-thickness tears, complete tears, tendinopathy (two datasets), supraspinatus tears, bursitis, arthritis, and overall tear detection. An extended dataset (n=207) was used for broad assessment of “any tear.” Results: The study population predominantly comprised males (78.7%) with a mean age of 39.7 ± 12.6 years. Most participants were right-hand dominant (97.7%) and had right-shoulder involvement (64.4%). USG identified 8 partial-thickness tears (3 true positives) while missing 10 MRI-confirmed cases. Tendinopathy detection varied, with 35 true positives in Set 1 and only 4 in Set 2. For “any tear,” USG demonstrated high accuracy in the large dataset (38 true positives). USG also performed well in identifying arthritis (45 true positives) and bursitis (39 true positives). Conclusion: USG is an effective first-line imaging tool for evaluating shoulder disorders, particularly fullthickness tears, bursitis, and arthritis. MRI remains essential for detecting subtle or partial-thickness tears.