Dr. Hind Khalid Abd Fahad Rotator cuff tears are common shoulder injuries that cause pain, weakness, and limited arm movement. The rotator cuff consists of four muscles and their tendons: supraspinatus, infraspinatus, subscapularis, and teres minor. These muscles stabilize the shoulder joint and facilitate arm movement. Ultrasound is widely used to diagnose rotator cuff tears because of its accessibility, relatively low cost, and lack of ionizing radiation. Role of Ultrasound in Diagnosis Ultrasound is an effective imaging modality for evaluating the rotator cuff tendons, particularly the supraspinatus tendon, which is frequently affected by tears. The examination is performed using a high-frequency linear transducer, providing detailed images of the tendons and surrounding soft tissues. Ultrasound can identify two main types of tears: • Partial-Thickness Tear: Appears as a focal hypoechoic defect within the tendon, with some tendon fibers remaining intact. • Full-Thickness Tear: Appears as a complete disruption of tendon continuity, sometimes associated with a fluid-filled gap. Dynamic ultrasound also allows real-time assessment of tendon movement during shoulder motion. Advantages and Limitations Ultrasound offers several advantages, including low cost, absence of ionizing radiation, and the ability to assess tendons dynamically. It also demonstrates good diagnostic accuracy, particularly for full-thickness tears. However, its accuracy depends on the operator’s experience, and small partial-thickness tears may be difficult to detect. MRI may be required in complex cases to provide a more comprehensive assessment. Conclusion Ultrasound is an effective and safe imaging modality for diagnosing rotator cuff tears of the shoulder. It helps identify the location and type of tear and allows dynamic assessment of the tendons. MRI remains an important complementary imaging method when more detailed evaluation is required. References 1. Farooqi AS, et al. Diagnostic Accuracy of Ultrasonography for Rotator Cuff Tears: A Systematic Review and Meta-analysis. Orthopaedic Journal of Sports Medicine. 2021;9(10). 2. Smith TO, et al. Diagnostic accuracy of ultrasound for rotator cuff tears: A systematic review and meta-analysis. Clinical Radiology. 2011.