Ultrasound accuracy in classifying full-thickness supraspinatus tear patterns: an arthroscopic correlation study

OBJECTIVES: To evaluate ultrasound's diagnostic value for full-thickness supraspinatus tendon (SST) tears and correlate it with arthroscopy findings. METHODS: In this retrospective study, patients with a clinical diagnosis of rotator cuff tears were included. The inclusion criteria were patients with shoulder joint pain and limited shoulder mobility. The exclusion criteria comprised patients who had undergone any previous shoulder surgery or those with shoulder fractures or dislocations. Ultrasound imaging features were observed and recorded, including measurements of the length and width of tears to reveal tear patterns. The chi-square test was used to compare the clinical characteristics of categorical variables, and the Wilcoxon test was used to assess the correlation between ultrasound and arthroscopy. RESULTS: From January 2023 to November 2023, 105 patients diagnosed with rotator cuff tears were included (50 males, 55 females, mean age 67.9 ± 14.2 years). Arthroscopy confirmed full-thickness SST tears in 82 patients (78.1%). Ultrasound demonstrated differential diagnostic performance across tear patterns: sensitivity/specificity 90.0%/95.8% (crescent), 93.1%/94.3% (U-shaped), 83.8%/98.0% (L-shaped), and 100%/98.6% (giant), with corresponding area under the ROC curves (AU-ROCs) of 0.789-0.882. Significant correlations were observed between ultrasound and arthroscopic measurements, particularly for crescent-type tear width (r = 0.949, P < .001). CONCLUSIONS: Ultrasound effectively distinguishes SST tear types, with high concordance to arthroscopy, supporting its use as a primary imaging tool for surgical planning in rotator cuff pathology. ADVANCES IN KNOWLEDGE: Ultrasound has significant application value in the diagnosis of full-thickness of SST tears. Ultrasound shows high consistency with arthroscopic findings and can effectively differentiate various tear patterns.