The Comparative Characteristic of Methods of Radial Diagnostics at Ruptures of the Rotator Cuff of the Shoulder

Logvinenko V. V.

METHODS AND METHODOLOGIES

Scentific article

Damages of a rotator cuff of a shoulder are extremely extended and can be both isolated and com­ ponents impingement a syndrome and instability of a humeral joint. In the literature of last years questions of com­ parison of diagnostic value of methods of radial diagnostics in revealing of tears of a rotator cuff of a shoulder are taken widely up. But basically the given sensitivities are cited, specificity and accuracy without comparison of radial symptoms on which basis the conclusions concerning tears of a rotator cuff of a shoulder are taken out. Research objective. To spend comparison ultrasonographical, magnetic resonance imaging, computed tomog­ raphy symptoms of tears of a rotator cuff of a shoulder, and also to define diagnostic value of an ultrasonography and a magnetic resonance imaging in revealing of full and partial tears of a rotator cuff of a shoulder and to compare it to the data of other researchers. Object and research methods. From 2009 on 2012 156 patients with damages of humeral joints, from them 110 (70,5 %) men, 46 (29,5 %) women are surveyed. On the basis of clinical signs and radial methods of researches patients have been parted on following groups: damages of a rotator cuff of a shoulder 67 (42,9 %) the person, impingement a syndrome of a humeral joint 46 (29,5 %) patients, instability of a humeral joint 43 (27,6 %) the pa­ tient. Tears of a rotator cuff of a shoulder are found out in all groups, in the first group they were isolated, and in the others were combined with lesions of other elements of a humeral joint. Operative treatment is spent 71 (45,5 %) to the patient. Definition of efficiency of radial methods of diagnostics spent by a technique of quality standard of a referential method and a method which is studied, by means of statistics of sensitivity, accuracy, specificity. The open operative measure was a referential method. Results of researches and their discussion. It is established that differences in reflexion of tears of a rotator cuff of a shoulder on ultrasonograms and magnetic resonance tomograms, depending on nosological unit at which they were taped, were not. The direct symptom – absence of visualisation of a cuff in a typical place was taped at all sur­ veyed with complete separations and was the general for both methods, indirect symptoms had the features bound to physicotechnical possibilities of methods of radial research. On computer tomograms because of low the X­ray of contrast of soft tissues was not defined direct symptoms of tears of a rotator cuff of a shoulder. High diagnostic value of methods of radial diagnostics is proved at full and partial tears of a rotator cuff of a shoulder: Sensitivity of a magnetic resonance imaging has made 100 % and 83,3 %, specificity of 95,8 % and 95,5 %, accuracy of 97,1 % and 91, 2 %, sensitivity of an ultrasonography has made 97,6 % and 84 %, specificity of 96,7 % and 95,6 %, accuracy of 97,2 % and 91,4 %. The majority of false results at an ultrasonography and a magnetic resonance imaging are errors in definition of completeness (thickness) of tears of tendons of a rotator cuff of a shoulder. Conclusions. The ultrasonography and a magnetic resonance imaging possess identical diagnostic value in revealing of full and partial tears of a rotator cuff of a shoulder. The obtained data essentially does not differ from given other researchers. In connection with various physicotechnical possibilities of methods, there are differences in techniques of carrying out of researches, radial signs of tears, measurement of the sizes of damages. For diag­ nosing of tears of a tendon it is necessary to tap a direct sign of tears is an absence of a tendon in a typical place at complete separations and defect of a tendon with or without replacement by a pathological tissue at partial tears.

a rotator cuff of a shoulder, ultrasonography, a magnetic resonance imaging

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«Bulletin of problems biology and medicine» Issue 3 part 2 (111), 2014 year, 266-270 pages, index UDK 616. 727. 2–001. 4/. 6–073. 75