Role and Correlation of High Resolution Ultrasound and Magnetic Resonance Imaging in Evaluation of Shoulder Pain in the Elderly

Abstract Background: Soft tissue lesions are a common cause of pain and disability in elderly people, clinical examination alone has a limited value in deciding on the management options for the underlying etiology. Several studies have been done that evaluated the accuracy of either magnetic resonance imaging or high-resolution ultrasound in detection of shoulder disorders and only few studies compared these two methods. Aim of Study: To evaluate the role of high-resolution ultrasonography and magnetic resonance imaging in elderly patients with shoulder pain. Patients and Methods: In this cross-sectional study, a total of 22 patients (11 females and 11 males). Were presented with acute shoulder joint pain. The patients were aged from 60 to 70 years. Results: Overall, we were able to demonstrate performance values for musculoskeletal ultrasound in diagnosing the abnormalities of rotator cuff, biceps tendon, acromioclavicular joint, and glenohumeral joint compared to MRI to be 100% for sensitivity. Positive predictive value (PPV) was 100% for rotator cuff, biceps tendon, and glenohumeral joint disorders, while it was 96% for the abnormalities developed in the acromioclavicular joint. Finally, the accuracy was 98.4%, 100%, 96%, and 100% respectively for the abnormalities of rotator cuff, biceps tendon, acromioclavicular joint, and glenohumeral joint disorders, respectively. Conclusion: Ultrasound for the shoulder joint presents a high accuracy and sensitivity in diagnosis a wide spectrum of shoulder joint lesions, with a diagnostic performance value near to that of MRI. Furthermore, it is a real time investigation that can afford comparison information of the two joints. A wide availability, lower cost and better tolerability of ultra-sonography make it a modality of first choice for evaluation of rotator cuff tears. MRI can be reserved for patients with suspicious ultrasonography results.