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[The significance of echographic signs in pathology of the rotator cuff].

Fifty-two patients, 17 acute and 35 chronic, underwent US of the shoulder. The first class of patients had clinical history of blunt trauma occurred 2 to 30 days before examination. The second class of patients included 15 patients with history of trauma occurred 3 months (or more) before examination and 20 patients affected with impingement syndrome. As to the US signs of rotator cuff tear reported in the literature, the results of the study, supported by arthrographic (21 cases), MR (2 cases) and surgical (24 cases) findings, indicate that their presence and significance differ in the acute and in the chronic patient and that: 1) Focal discontinuity, appearing as a hypoechoic area, is demonstrable only in the acute patient. The sign is due to a tear filled with blood and/or bursal liquid and holds high diagnostic accuracy. It is rare that an acute lesion appears as a hyperechoic linear density--which has doubtful diagnostic accuracy. 2) Non-visualization of the cuff is observable in both the acute and the chronic patient and indicates rupture in both of them. This sign has high diagnostic accuracy. 3) Thinning of the cuff is also observable both in the acute and in the chronic patient. Nevertheless, while in the former the sign can be regarded with confidence as indicating a tear in almost all cases, in the latter it may be due either to a tear or to degeneration. Arthrography or MR Imaging are therefore advisable in this group of patients, especially if surgical treatment is considered.