抄録
(Purpose)The purpose of this study is to evaluate the sonographic diagnosis of subacromial impingement syndrome (SIS) e. g. subacromial bursitis and/or tendinitis (Grade I) and incomplete rotator cuff tears(Grade II).
(Materials and methods)83 cases of SIS were operated on from 1994 to 1996 after a sonographic examination using a Toshiba SSA-250A with a 7.5 MHz by the same staff member. There were 24 Grade I, 20 Grade II(8 bursal-side tears; BT,4 intratendinous tears; I T, and 8 joint-side tears; JT), and 39 Grade III (complete rotator cuff tears)lesions. The diagnostic criteria for Grade I were a thickend cuff tendon and/or fluid collection in the bursa, and for Grade II, surface irregularity and/or echogenic material in the cuff tendon. At operation, palpations, color tests and a trial tenotomy were variously employed to confirm any concealed pathology. Comparisons were made between the preoperative sonograms and operative findings.
(Results)In Grade I lesions, the sensitivity was 41.7%, specificity,80%, positive predictive value,71.4%and accuracy,59.1%. In Grade II lesions, consisting of BT, It and JT, the sensitivities were 75%,50% and 12.5% respectively, specificies,80.6%,85% and 94.4%, the positive predictive values.46.2%,25% and 33.3%, and accuracies,79.5%,81.8% and 79.5%.
(Discussion)This is the first report on the sonographic diagnostic rate concerning the BT, IT, and JT separately. The sonographic diagnosis of IT was effective.
(Summary)1) Sonographic findings in subacromial bursitis, tendinitis and incomplete rotator cuff tears were compaired with the operative findings.2)The accuracy of the sonographic diagnosis was 59.1% in Grade I lesions and 79.5% in BT,81.8% in IT and 79.5% in JT.3) Sonographic screening of IT was useful in deciding on a trial tenotomy.
