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Archives of Orthopaedic and Trauma Surgery

, Volume 139, Issue 5, pp 659–667 | Cite as

Accuracy of magnetic resonance imaging (MRI) for subscapularis tear: a systematic review and meta-analysis of diagnostic studies

  • Eduardo Angeli Malavolta
  • Jorge Henrique AssunçãoEmail author
  • Mauro Emilio Conforto Gracitelli
  • Talitha Koo Yen
  • Marcelo Bordalo-Rodrigues
  • Arnaldo Amado Ferreira Neto
Arthroscopy and Sports Medicine
  • 116 Downloads

Abstract

Introduction

The accuracy of MRI for subscapularis tear is lower than that of overall rotator cuff tears. Until now, no systematic reviews and meta-analysis have been conducted to compile these data. The purpose of this study was to determine, through a systematic review and meta-analysis, the diagnostic accuracy of MRI in the detection of subscapularis tendon tears.

Materials and methods

A systematic review of PubMed, EMBASE, and MEDLINE databases up to April 2017 was performed. All studies assessing the sensitivity and specificity of the MRI (index test) compared to arthroscopic surgical findings (reference test) for subscapularis tendon tear were included. A meta-analysis was performed to calculate pooled sensitivity, specificity, sROC curve, and diagnostic odds ratio values.

Results

A total of 497 citations were identified. After applying the eligibility criteria, 14 articles were included, including 1858 shoulders with 613 subscapularis tears. For overall subscapularis tears, sensitivity was 0.68 (95% CI 0.64–0.72) and specificity was 0.90 (95% CI 0.89–0.92). Sensitivity was 0.93 (95% CI 0.83–0.98) for full-thickness tears and 0.74 (95% CI 0.66–0.82) for partial tears. Specificity was 0.97 (95% CI 0.94–0.98) for full-thickness tears and 0.88 (95% CI 0.85–0.91) for partial tears. Analyzing only studies with field of strength ≥ 1.5 T, sensitivity was 0.80 (95% CI 0.76–0.84) and specificity 0.84 (95% CI 0.81–0.87).

Conclusion

MRI is an accurate method for diagnosing subscapularis tendon tears; however, its accuracy is lower than that of overall rotator cuff tears, due to its lower sensitivity.

Level of evidence

III, systematic review of Level II and III studies.

Keywords

Rotator cuff tear MR imaging Subscapularis tendon Accuracy Sensitivity Specificity 

Notes

Funding

None.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

This article does not contain any studies with human participants or animals performed by any of the authors.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • Eduardo Angeli Malavolta
    • 1
  • Jorge Henrique Assunção
    • 1
    Email author
  • Mauro Emilio Conforto Gracitelli
    • 1
  • Talitha Koo Yen
    • 1
  • Marcelo Bordalo-Rodrigues
    • 1
  • Arnaldo Amado Ferreira Neto
    • 1
  1. 1.Department of Orthopedics and Traumatology, School of MedicineUniversity of São PauloSão PauloBrazil

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