Shoulder Position During Magnetic Resonance Arthrogram Significantly Affects Capsular Measurements
| Autor: | William R. Barfield, Richard J. Friedman, Meghana V. Rao, Alyssa R. Greenhouse, Harris S. Slone, Jackie J. Lin, Venkatraman Kothandaraman, Josef K. Eichinger, Russell W. Chapin, Charles Cody White |
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| Rok vydání: | 2020 |
| Předmět: |
Adult
Joint Instability Male Shoulder Adolescent Rotation Shoulders Joint Dislocations Patient Positioning 030218 nuclear medicine & medical imaging 03 medical and health sciences Young Adult 0302 clinical medicine medicine Humans Orthopedics and Sports Medicine Arthrography Retrospective Studies Subluxation 030222 orthopedics medicine.diagnostic_test business.industry Shoulder Joint Internal rotation Reproducibility of Results Magnetic resonance imaging Middle Aged Control subjects medicine.disease Magnetic Resonance Imaging Scapula medicine.anatomical_structure External rotation Multivariate Analysis Humeral Head Shoulder joint Female Arthrogram Nuclear medicine business |
| Zdroj: | Arthroscopy : the journal of arthroscopicrelated surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association. 37(1) |
| ISSN: | 1526-3231 |
| Popis: | To determine whether change in shoulder position between internal rotation (IR) and external rotation (ER) during magnetic resonance arthrography (MRA) affects previously defined capsular measurements and to determine the utility of rotation in the diagnosis of instability.A retrospective study was conducted of patients who received a shoulder MRA with humeral IR and ER views. Patients with an arthroscopically confirmed diagnosis of instability and those with clinically stable shoulders, no history of instability, and no MRA findings of instability were identified and compared. Humeral rotation, glenoid retroversion, humeral head subluxation, capsular length, and capsular area using axial sequences of IR and ER views were recorded. Analysis compared IR, ER, and Δ capsular measurements between groups using independent t tests and univariate and multivariate regression.Thirty-one subjects who were diagnosed with instability were included, along with 28 control subjects. Capsular length, capsular area, and humeral subluxations were significantly greater with ER compared with IR views (P.001, P.001, P.001). Patients with instability displayed greater ER capsular length (P = .0006) and ER capsular area (P = .005) relative to controls. Multivariate logistic regression identified age, weight, sex, ER capsular length, and retroversion to be significant predictors of instability. ER capsular length independently predicts instability with 86% sensitivity and 84% specificity. Interobserver reliability using the intraclass correlation coefficient was rated good or excellent on all measurements.Variance in humeral rotation during shoulder MRA significantly affects capsular measurements. Rotational views increase the utility of capsular measurements when assessing for instability, particularly capsular length and capsular area. The implementation of ER positioning enhances the ability to examine capsular changes of the shoulder joint and can assist in the diagnosis of instability.III, retrospective comparative study. |
| Databáze: | OpenAIRE |
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