Question:Is it possible to have a normal tendon show up as torn on an ultrasound study? I just had an MRI and an ultrasound. The MRI was normal but the US showed a tear in my rotator cuff. Which test should I believe?
Depend on your doctor's final word to guide you. Doctors rarely rely on imaging studies without knowing the patient's history and doing an exam. Many clinical tests can be done to find the exact tendon that's involved.
A misdiagnosed torn rotator cuff usually goes the other way. In other words, there's a tear but the image shows a normal tendon. It would be rare (but possible) to have a normal tendon diagnosed as torn. This could occur when there is what's called an artifact, a blip in the picture. Artifacts come from extra electronic signals. Another possible reason for a wrong diagnosis is that the radiologist looking at the image can misread it.
One benefit to in-office ultrasound testing for orthopedic surgeons is the doctor's knowledge of the patient. The patient doesn't have to depend on the results read by a radiologist who has never seen the patient.
The surgeon has the advantage when looking at the image of knowing how the patient presented. The test can be done at the time of the exam, saving the patient from having to make another appointment on another day.Joseph P. Iannotti, MD, PhD et al. Accuracy of Office-Based Ultrasonography of the Shoulder for the Diagnosis of Rotator Cuff Tears. In The Journal of Bone and Joint Surgery. June 2005. Vol. 87-A. No. 6. Pp. 1305-1311.
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