DR. MARIA MURTAZA , DR MUHAMMAD AQEEL BABRI , DR. AFAF ARIF , DR. HASSAN RASHID ,
DOI: https://doi.org/Background: Rotator cuff tears are a common cause of shoulder pain and functional limitation. Accurate diagnosis is essential for appropriate management. While indirect MR arthrography (MRA) is considered the gold standard, plain MRI is widely used due to its non-invasive nature.
Objectives: To determine the diagnostic accuracy of plain MRI in detecting rotator cuff tears, using indirect MR arthrography as the reference standard, and to evaluate its performance across different patient subgroups.
Study Design & Setting: Cross-sectional validated study conducted at the Department of Radiology, Ittefaq Hospital Trust, Lahore from July 2025 to October 2025.
Methodology: A total of 125 patients aged 2070 years with clinical suspicion of rotator cuff tear were enrolled using consecutive sampling. All patients underwent plain MRI followed by indirect MRA in the same imaging session. Images were independently interpreted by two experienced radiologists blinded to each others findings. Diagnostic performance of plain MRI was assessed using 2×2 contingency tables, calculating sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and overall accuracy. Stratification was performed by age, gender, and duration of symptoms.
Results: Plain MRI detected 76/125 tears compared to 82/125 on indirect MRA. Overall sensitivity and specificity were 86.6% and 88.4%, respectively, with a PPV of 93.4%, NPV of 77.6%, and overall accuracy of 87.2%. Stratified analysis demonstrated high diagnostic performance across age, gender, and symptom duration subgroups, with statistically significant differences (p < 0.001).
Conclusion: Plain MRI shows high diagnostic accuracy for detecting rotator cuff tears and may serve as a reliable non-invasive imaging modality, though indirect MRA remains the gold standard.
