Evaluation of the role of dynamic ultrasonography versus magnetic resonance imaging in diagnosis and assessment of shoulder impingement syndrome

Authors

1 Professor of Radiodiagnosis, Faculty of Medicine, Al-Azhar University (Assiut)

2 Assistant Professor of rheumatology, Faculty of Medicine, Al-Azhar University (Assiut)

3 Resident of Radiodiagnosis, Faculty of medicine, Al-Azhar University hospital (Assiut)

Abstract

Background: Shoulder impingement is the most common cause of shoulder pain. Ultrasonography (US) and magnetic resonance imaging (MRI) has a vital role for diagnosing shoulder impingement and rotator cuff pathologies. Aim: To compare between dynamic high resolution US and MRI which used as a reference standard in the in the diagnosis and assessment of impingement syndrome in examination of the shoulder joint. Patients and Methods: This study was performed on 30 cases with suspected shoulder impingement syndrome in the X-ray department of Al-azhar Assuit University Hospital. Patients with known contraindications for MRI examination were excluded. All patients underwent a correct medical history and clinical examination, grayscale ultrasound and MRI scan. Result: According to the dynamic ultrasound results, 33.3% had rotator cuff tendinitis, 10.0% calcified tendinitis, 43.3% partial tear, 26.7% complete tear, 63, 3% acromioclavicular arthritis, 3% gout, 3% osteoarthritis, osteoarthritis and 16.7% biceps tendonitis. Conclusion: Dynamic ultrasound can be used as a first-line imaging modality in patients with shoulder pain. MRI can be used in situations where ultrasound diagnosis is inconclusive. In most cases, a properly performed ultrasound avoids the need for various diagnostic tests such as arthrography and MRI. Ultrasound, which is non-invasive, non-ionizing, and widely available, combined with low cost and the advantages of real-time dynamic assessment, may be the most cost-effective imaging modality for detecting impingement syndrome.

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