Comparative Evaluation of Magnetic Resonance Imaging Request Accuracy for Suspected Rotator Cuff Tears Across Medical Specialties

Abstract

Objective: The diagnosis of shoulder pathologies is a multidisciplinary process that includes physical examination, anamnesis and imaging techniques such as magnetic resonance imaging (MRI). Nevertheless, the inappropriate utilization of these imaging modalities engenders an unwarranted increase in workload and financial expenditure. The objective of the present study was to compare the appropriateness and diagnostic effectiveness of shoulder MRI requests for suspected rotator cuff tears across departments.

Material and Methods: In this retrospective study, shoulder MRIs requested by five different physician groups with a preliminary diagnosis of rotator cuff pathology were analyzed: orthopedic specialists, orthopedic residents, physical therapy and rehabilitation (PTR) specialists, PTR residents, and physicians from other specialties (neurosurgery and internal medicine). MRI requests that included other preliminary diagnoses, as well as unreported or unconfirmed MRI scans, were excluded from the study.

Results: A total of 712 MRIs were analyzed. Among the MRI examinations requested by orthopedic specialists, the rate of full-thickness rotator cuff tears was 21.4%, while the rate of partial-thickness tears was 16.7%. When both partial- and full-thickness tears were considered together, the overall rotator cuff tear rate was 38.1%. A statistically significant difference was observed in the detection rates of full-thickness tears between orthopedic physicians and other specialists (p = 0.029). A significant difference was also found between the groups in the diagnosis of isolated partial-thickness tears (p = 0.048). No significant difference was observed between orthopedic specialists and PTR specialists (p > 0.05). Among physicians from other specialties, despite MRI requests indicating a preliminary diagnosis of rotator cuff pathology, shoulder examinations were either not performed or inadequately documented.

Conclusion: The study demonstrated that orthopedic and PTR specialists were significantly more likely to request MRIs appropriately. In the context of escalating healthcare expenditures, the implementation of restrictive regulations for non-specialist departments is recommended.

Cite as: Aman T, Gencer B, Eşkara H, Korkmaz TC, Kendirci AŞ. Comparative evaluation of magnetic resonance imaging request accuracy for suspected rotator cuff tears across medical specialties. Turk J Sports Med. 2026; https://doi.org/10.47447/tjsm.0951

The approval for this study was obtained from University of Health Sciences, Sancaktepe ¸Şehit Prof. Dr. İlhan Varank Training and Research Hospital Clinical Research Ethics Committee, E-46059653-050.99-251432198 (Decision no: 2024/231, Date: 14/08/2024).

Concept: TA,AŞK; design: TA,TCK; supervision: BG; materials: TA,TCK; data collection and/or processing: TA,HE; analysis and interpretation: BG; literature review: TA,AŞK; writing manuscript: TA; critical reviews: HE. All authors contributed to the final version of the manuscript and discussed the results and contributed to the final manuscript.

The authors declared no conflicts of interest with respect to authorship and/or publication of the article.

The authors received no financial support for the research and/or publication of this article.