Calcific Tendinosis Reduces Diagnostic Performance of Magnetic Resonance Imaging in the Detection of Rotator Cuff Tears

Objective This study aimed to investigate the effect of calcific tendinosis on the diagnosis of rotator cuff tears (RCTs) on magnetic resonance imaging (MRI) and magnetic resonance arthrography (MRA). Materials and Methods Calcific tendinosis was confirmed radiographically. Two musculoskeletal radiologists then retrospectively and independently reviewed the MRI/MRA examinations, with surgery or arthroscopy performed within 90 days of the MRI. Rotator cuffs were categorized as no tear, partial-thickness tear, and full-thickness tear. Partial-thickness tear/full-thickness tear groups were combined for analysis. Results Forty-eight MRI (mean age, 63.4 years; range, 37-83 years; female-to-male ratio, 29:19) and 7 MRA (mean age, 49.2 years; range, 25-60 years; female-to-male ratio, 4:3) patients were included. Reader 1 and reader 2 sensitivity/specificity values for RCTs on MRI were 95%/50% and 89%/30%, and the values on MRA were 100%/67% and 100%/100%, respectively. Overall agreement was present in 87% (48 of 55; kappa = 0.55 [95% confidence interval, 0.26-0.85]). Conclusions Magnetic resonance imaging has decreased specificity in diagnosing RCTs when calcific tendinosis is present. Magnetic resonance arthrography performed better in this population and could be considered.