Sensitivity and specificity of ultrasonography in early diagnosis of metatarsal bone stress fractures: a pilot study of 37 patients
| Autor: | Alain Goldcher, Koeger Ac, Frédérique Gandjbakhch, Frédéric Banal, Bruno Fautrel, Sylvie Rozenberg, Pierre Bourgeois, Fabien Etchepare, Violaine Foltz |
|---|---|
| Rok vydání: | 2009 |
| Předmět: |
Adult
Male medicine.medical_specialty Fractures Stress Radiography Immunology Pilot Projects Scintigraphy Sensitivity and Specificity Fractures Bone Young Adult Rheumatology Predictive Value of Tests Internal medicine medicine Immunology and Allergy Humans Prospective Studies Metatarsal Bones Aged Aged 80 and over Stress fractures medicine.diagnostic_test business.industry Reproducibility of Results Magnetic resonance imaging Ultrasonography Doppler Gold standard (test) Middle Aged Reference Standards medicine.disease Early Diagnosis Predictive value of tests Case-Control Studies Female Radiology Metatarsal bones business |
| Zdroj: | The Journal of rheumatology. 36(8) |
| ISSN: | 0315-162X |
| Popis: | Objective.To date, early diagnosis of stress fractures depends on magnetic resonance imaging (MRI) or bone scan scintigraphy, as radiographs are usually normal at onset of symptoms. These examinations are expensive or invasive, time-consuming, and poorly accessible. A recent report has shown the ability of ultrasonography (US) to detect early stress fractures. Our objective was to evaluate sensitivity and specificity of US versus dedicated MRI (0.2 Tesla), taken as the gold standard, in early diagnosis of metatarsal bone stress fractures.Methods.A case-control study from November 2006 to December 2007 was performed. All consecutive patients with mechanical pain and swelling of the metatarsal region for less than 3 months and with normal radiographs were included. US and dedicated MRI examinations of the metatarsal bones were performed the same day by experienced rheumatologists with expertise in US and MRI. Reading was undertaken blind to the clinical assessment and MRI/US results.Results.Forty-one feet were analyzed on US and dedicated MRI from 37 patients (28 women, 9 men, mean age 52.7 ± 14.1 yrs). MRI detected 13 fractures in 12 patients. Sensitivity of US was 83%, specificity 76%, positive predictive value 59%, and negative predictive value 92%. Positive likehood ratio was 3.45, negative likehood ratio 0.22.Conclusion.In cases of normal radiographs, US is indicated in the diagnosis of metatarsal bone stress fractures, as it is a low cost, noninvasive, rapid, and easy technique with good sensitivity and specificity. From these data, we propose a new imaging algorithm including US. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|