Abstract
Background: #Subscapularistears often occur in combination
with various shoulder problems. Untreated, they can lead to persisted
symptoms even after rotator cuff surgery. Clinical tests, #magneticresonance imaging (MRI) and magnetic resonance arthrography (MRA)
are being used to evaluate subscapularis integrity. Reviews regarding
publications till 2012, however, show poor sensitivity in detecting
subscapularis tears prior to surgery. Recent technological development
might have led to improvement.
Method: A mini systematic review of the PubMed database of the
last 5 years was made. Studies comparing MRI/MRA (index tests) to
open- and #arthroscopic surgical findings (reference test) and recording
different types of subscapularis tears were included. Methodological
appraisal was performed using QUADAS 2.
Results: In four retrospective studies, comprising 811
patients who underwent shoulder surgery, 264 subscapularis tears were
identified
by arthroscopy (prevalence 32.6%). The sensitivity for detecting full
thickness tears varied from 93% to 100%. The sensitivity for detecting
partial tears varied from 54% to 81%. There were high concerns regarding
the index test bias and applicability in 3 of 4 studies. The lack of
consensus in the classification of subscapularis tears led to a high
level of heterogeneity in these studies and made it impossible to pool
data.
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