Anterior Shoulder Instability: Correlation Between Magnetic Resonance Arthrography, Ultrasound Arthrography and Intraoperative Findings

Simão, Marcelo Novelino; Nogueira-Barbosa, Marcello Henrique; Muglia, Valdair Francisco; Barbieri, Cláudio Henrique

doi:10.1016/j.ultrasmedbio.2011.12.021

Cited by 14 publications

(19 citation statements)

References 15 publications

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“…Of these shoulders, 27 were from studies of cadaveric specimens and 2,533 were from studies of clinical patients with anterior shoulder instability. When the articles were further broken down by the evaluated imaging modalities, there were 4 articles on ultrasound, 10,19,29,37 5 articles on radiographic imaging, 11,34,36,37,44 10 articles on MRI, 17,[21][22][23]30,35,38,[48][49][50] 12 articles on MRA, 15,24,25,[27][28][29][31][32][33]40,42,46 2 articles on 2D CT, 35,41 7 articles on CTA, 14,18,19,20,22,24,26 and 5 articles on 3D CT 16,39,43,45,47 (Table 2).…”

Section: Resultsmentioning

confidence: 99%

“…10,11,14,15,[17][18][19][20][21][22][23]25,[27][28][29][30][31][32][33][34] Three of these articles specifically evaluated ultrasound. 10,19,29 In the detection of Hill-Sachs lesions, the reported range of sensitivity was 74% to 96%; specificity, 60% to 95%; and accuracy, 94% to 95%. 10,19,29 One study determined the PPV and NPV to be 76% and 62%, respectively.…”

Section: Diagnosing Presence Of Hill-sachs Lesionsmentioning

confidence: 99%

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Accuracy and Reliability of Imaging Modalities for the Diagnosis and Quantification of Hill-Sachs Lesions: A Systematic Review

Vopat

Peebles

McBride

et al. 2021

Arthroscopy: The Journal of Arthroscopic & Related Surgery

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Purpose: To determine the reliability and accuracy of different imaging modalities in assessing Hill-Sachs lesions within the setting of anterior shoulder instability. Methods: A systematic review was performed according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) guidelines using the PubMed, Scopus, Embase, and Cochrane Library databases. The inclusion criteria were clinical trials or cadaveric studies that assessed the accuracy of humeral head bone loss imaging or reliability and English-language articles. The exclusion criteria were animal studies; imaging studies without measures of accuracy, reliability, or clinical predictive power; studies of shoulder injuries without humeral head bone loss; editorials; abstracts; reviews; case reports; and surveys. The search terms included "imaging" OR "radiographic" OR "CT" OR "MRI" AND "Hill-Sachs" OR "humeral head bone loss." Assessment of the methodologic quality of the included studies was performed using the original Quality Assessment of Diagnostic Accuracy Studies (QUADAS) tool. Results: Forty studies (2,560 shoulders) met the inclusion criteria and were assessed. For diagnosing the presence of Hill-Sachs lesions, computed tomography (CT) arthrography had the highest reported accuracy (median, 91%; range, 66%-100%). For the same assessment, CT arthrography also had the greatest reported sensitivity (median, 94%; range, 50%-100%). For the quantification of Hill-Sachs lesion parameters, reported intraobserver reliabilities were highest for 3-dimensional (3D) CT (intraclass correlation coefficient [ICC] range, 0.916-0.999), followed by 2-dimensional CT (ICC range, 0.858-0.861) and magnetic resonance imaging (MRI) (ICC range, 0.28-0.97). For the same quantification parameters, interobserver reliabilities were also reported for 3D CT (ICC range, 0.772-0.996), 2-dimensional CT (ICC range, 0.721-0.879), and MRI (k range, 0.444-0.700). Intraobserver reliabilities for determining glenoid tracking were only reported for 3D CT (k range, 0.730-1.00; ICC range, 0.803-0.901) and MRI (ICC range, 0.770-0.790). Conclusions: This study shows that the current literature supports a variety of different imaging modalities that provide clinically acceptable accuracy in diagnosing and quantifying Hill-Sachs lesions, as well as determining whether they will cause persistent anterior shoulder instability. Furthermore, this systematic review justifies that further research is needed to help develop a treatment algorithm on the proper imaging modalities needed to help treat patients with anterior shoulder instability that is both reliable and financially acceptable. Level of Evidence: Level IV, systematic review of Level I through IV studies.

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Section: Resultsmentioning

confidence: 99%

Section: Diagnosing Presence Of Hill-sachs Lesionsmentioning

confidence: 99%

Accuracy and Reliability of Imaging Modalities for the Diagnosis and Quantification of Hill-Sachs Lesions: A Systematic Review

Vopat

Peebles

McBride

et al. 2021

Arthroscopy: The Journal of Arthroscopic & Related Surgery

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“…They also reported that MRI had a sensitivity of 80–100% and a specificity of 50–100% in comparison to US. 13 …”

Section: Discussionmentioning

confidence: 99%

Accuracy of point-of-care ultrasound using low frequency curvilinear transducer in the diagnosis of shoulder dislocation and confirmation of appropriate reduction

Seyedhosseini

Saiidian

Taheri

et al. 2017

Turkish Journal of Emergency Medicine

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BackgroundUltrasound (US) is an effective modality in the evaluation of shoulder dislocation and reduction. In most studies, high frequency US probes have been used.ObjectiveTo determine the sensitivity and specificity of low frequency US in the diagnosis of shoulder dislocation and its proper reduction in the emergency department (ED).MethodsIn a prospective observational study 84 patients, suspicious of shoulder dislocation, were enrolled in our study. In ED, they all underwent low frequency (curve) probe US examination by the emergency physician at the time of admission. Standard radiographies of their shoulder joints were taken later and then reported by the attending radiologist. As soon as the shoulder dislocation was confirmed, reduction of the joint was done under procedural sedation and analgesia. US and radiography of the relocated joint were taken for the second time. The sensitivity and specificity of low frequency US were compared with radiography by the appropriate statistical analysis.ResultsIn comparison to radiography, US had a sensitivity of 100.0%, specificity of 80.0%, positive predictive value of 98.7%, and negative predictive value of 100.0% in diagnosis of shoulder dislocation. The specificity of US in diagnosis of proper reduction of the joint, was estimated to be 98.7% with a negative predictive value of 100.0%. US took a significantly less time than radiography to be performed (p < 0.001).ConclusionsLow frequency US is highly accurate in diagnosing shoulder dislocation and its proper reduction. Thus it might be a good substitute for radiography in these situations.

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“…Although clinical tests may suggest a diagnosis of labral tear, their sensitivity and specificity are relatively low ( 2 , 20 ) . Various methods, such as ultrasound and computed tomography arthrography, have been tested as means of evaluating labral anatomy and pathology ( 21 - 23 ) . However, MRI and MR arthrography are considered the most reliable methods for diagnosing superior labral anatomy and pathology ( 14 , 15 , 24 ) .…”

Section: Discussionmentioning

confidence: 99%

Magnetic resonance imaging evaluation of meniscoid superior labrum: normal variant or superior labral tear

2016

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ObjectiveThe objective of this study was to determine the incidence of a "meniscoid" superior labrum.Materials and MethodsThis was a retrospective analysis of 582 magnetic resonance imaging examinations of shoulders. Of those 582 examinations, 110 were excluded, for a variety of reasons, and the final analysis therefore included 472 cases. Consensus readings were performed by three musculoskeletal radiologists using specific criteria to diagnose meniscoid labra.ResultsA meniscoid superior labrum was identified in 48 (10.2%) of the 472 cases evaluated. Arthroscopic proof was available in 21 cases (43.8%). In 10 (47.6%) of those 21 cases, the operative report did not include the mention a superior labral tear, thus suggesting the presence of a meniscoid labrum. In only one of those cases were there specific comments about a mobile superior labrum (i.e., meniscoid labrum). In the remaining 11 (52.4%), surgical correlation demonstrated superior labral tears.ConclusionA meniscoid superior labrum is not an infrequent finding. Depending upon assumptions and the requirement of surgical proof, the prevalence of a meniscoid superior labrum in this study was between 2.1% (surgically proven) and 4.8% (projected). However, superior labral tears are just as common and are often confused with meniscoid labra.

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Anterior Shoulder Instability: Correlation Between Magnetic Resonance Arthrography, Ultrasound Arthrography and Intraoperative Findings

Cited by 14 publications

References 15 publications

Accuracy and Reliability of Imaging Modalities for the Diagnosis and Quantification of Hill-Sachs Lesions: A Systematic Review

Accuracy and Reliability of Imaging Modalities for the Diagnosis and Quantification of Hill-Sachs Lesions: A Systematic Review

Accuracy of point-of-care ultrasound using low frequency curvilinear transducer in the diagnosis of shoulder dislocation and confirmation of appropriate reduction

Magnetic resonance imaging evaluation of meniscoid superior labrum: normal variant or superior labral tear

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