Sonographic Evaluation of Subscapularis Tendon Tears with Surgical Correlation

Aims: The purpose of this study was to evaluate the ability of ultrasound in detecting subscapularis tendon pathology with operative correlation.

Methodology: A retrospective study was conducted on 86 patients who had shoulder ultrasound prior to surgical repair from January 2006 to August 2008. All sonographic examinations and surgical reports were reviewed. Sonographic evaluation of subscapularis tendon, including normal, tendinosis, partial thickness tear, full thickness tear, and complete tear were correlated to operative reports.

Results: Of the 86 patients, 19 patients had surgically proven abnormal subscapularis tendons. There was 100% ultrasound concordance in tendinosis (n = 1), 100 % ultrasound concordance in partial thickness tears (n =3), 88 % ultrasound concordance in full thickness tears (n = 8), 57 % ultrasound concordance in complete tears (n = 7). Overall, there was 79% ultrasound concordance in diagnosing subscapularis tendon pathology when surgery is used as a gold standard.

Conclusion: Ultrasound is useful in the evaluation of the subscapularis tendon. The sonographic findings of tendinosis and partial thickness tears correlate best with surgery. However, ultrasound may underestimate complete tears.