Diagnostic performance of ultrasound for rotator cuff tears: a systematic review and meta-analysis

Aim: Rotator cuff (RC) tears are considered to be the main reason for shoulder pain. Although ultrasound is a useful method to detect it, its effectiveness when diagnosing RC tears has been a heated discussion. Therefore, we aimed at evaluating RC tears' ultrasound accuracy by conducting a systemically review and pooled comprehensive analysis. Materials and methods: Relevant articles up to May 2018 were searched from the Cochrane Library, Embase, and Pubmed databases. Either arthroscopy or magnetic resonance imaging (MRI) was considered as a reference standard. The results were estimated by pooled-sensitivity (P-SEN), pooled-specificity (P-SPE), pooled-diagnostic odds ratio (P-DOR), pooled-likelihood ratio+ (P-LR+), pooled-likelihood ratio- (P-LR-), and the area under the summary receiver operating characteristic (SROC). Result: We selected seven prospective studies in accordance with the inclusion criteria that covered 554 rotator cuff tears in 868 patients. The P-SEN, P-SPE, P-LR+, P-LR-, P-DOR, area under the SROC curve of diagnostic performance of ultrasound for RC and post-test probability were 95% (95% CI: 88 - 98), 72% (95% CI: 61 - 81), 3.41 (95% CI: 2.40 - 4.84), 0.08 (95% CI: 0.03 - 0.16), 45.31 (95% CI: 21.04 - 97.59), 89% (95% CI: 0.86 - 0.91), and 46% and 2%, respectively. Conclusion: Our meta-analysis demonstrates that ultrasound has a high efficiency for RC tears' diagnosis. It can be a promising method in patients with suspected RC tears because of its high sensitivity, specificity and diagnostic accuracy.