Comparative Evaluation of Ultrasonography and Mri in Diagnosing Shoulder Joint Pathologies: A Prospective Cross-Sectional Study

Background: Shoulder joint pathologies are among the most common musculoskeletal complaints and present a diagnostic challenge due to complex anatomy and overlapping clinical features. While ultrasonography (USG) is increasingly used for its accessibility and dynamic assessment capabilities,magnetic resonance imaging (MRI) remains the gold standard.This study aimed to evaluate the diagnostic accuracy of USG compared to MRI in detecting shoulder pathologies. Materials And Methods: A prospective cross-sectional observational study was conducted over 18 months on 40 patients presenting with shoulder pain or suspected internal derangement. All patients underwent both USG and MRI, and findings were independently interpreted. MRI served as the reference standard to calculate the sensitivity, specificity, and diagnostic accuracy of USG. Results: The majority of patients were males (72.5%), with predominant right shoulder involvement (72.5%), and most were aged 21–60 years. MRI detected a greater number of pathologies compared to USG, particularly in supraspinatus tendinosis (6 vs. 4), partial supraspinatus tears (11 vs. 8), subscapularis tears (1 vs.0),and instability-related lesions such as Bankart's (5 vs.1) and Hill-Sachs lesions (6 vs.4).USG showed high specificity (>90%) in most pathologies but lower sensitivity in deeper structures: 75% for supraspinatus tear, 50% for infraspinatus tear, and 0% for subscapularis tear.Biceps dislocation was detected with 100% accuracy by USG. Subdeltoid collections had the lowest sensitivity (33.3%). MRI also revealed labral tears, marrow edema, and contrast enhancement—features missed by USG. Conclusion: USG is a reliable screening tool for common and superficial shoulder lesions but has limitations in detecting deep,complex,or intra-articular pathology,reaffirming MRI as the gold standard in such cases.