Magnetic Resonance Arthrogram and Arthroscopy of the Shoulder: A Comparative Retrospective Study with Emphasis on Posterior Labral Lesions and Radiologist Locality
| Autor: | John M. Geoghegan, Lennard Funk, Nicholas S. Kalson |
|---|---|
| Rok vydání: | 2011 |
| Předmět: |
musculoskeletal diseases
030222 orthopedics medicine.medical_specialty medicine.diagnostic_test business.industry Rehabilitation Arthroscopy Physical Therapy Sports Therapy and Rehabilitation Retrospective cohort study Magnetic resonance imaging 030229 sport sciences Gold standard (test) 03 medical and health sciences 0302 clinical medicine medicine Orthopedics and Sports Medicine Surgery Arthrogram Radiology business Diagnostic arthroscopy |
| Zdroj: | Shoulder & Elbow. 3:210-214 |
| ISSN: | 1758-5740 1758-5732 |
| DOI: | 10.1111/j.1758-5740.2011.00149.x |
| Popis: | Background Magnetic resonance arthrography(MRA) is a routine diagnostic investigation for glenohumeral lesions; however, diagnostic arthroscopy remains the gold standard. The present study aimed tto investigate the diagnostic accuracy of glenohumeral MRA compared to arthroscopy, with particular interest in previously unreported aspects, such as posterior labral lesions and the locality of the reporting radiologists. Methods Ninety-five consecutive patients with pre-operative MRA and subsequent arthroscopy were included. Patients were grouped into MRA reported by specialist radiologists within the specialist shoulder unit ( n = 58) or reported by nonlocal musculoskeletal radiologists ( n = 37). Results In the local radiologist group, the sensitivity/specificity for Hill – Sachs lesions was 0.71/0.85, anterior labral tears 0.75/0.73, posterior labral tears 0.50/0.92, superior labral tear from anterior to posterior (SLAP) lesions 0.71/0/91 and rotator cuff tears (RCTs) 0.40/0.81. In the nonlocal radiologist group, the sensitivity/specificity for Hill – Sachs lesions was 0.64/0.88, anterior labral tears 0.70/0.79, posterior labral tears 0.40/0.81, SLAP lesions 0.66/0/82 and RCT 0.40/0.81. A nonsignificant trend of lower sensitivity/specificity for lesions reviewed by the nonlocal radiologists was found. Discussion MRA is not 100% sensitive or specific and does not negate arthroscopy. There is a lower diagnostic accuracy of posterior compared to anterior labral lesions and improved accuracy of glenohumeral MRA diagnosis may be achieved with the increased experience of radiologists within specialist units and regular surgical feedback of cases. |
| Databáze: | OpenAIRE |
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