Limited diagnostic accuracy of magnetic resonance imaging and clinical tests for detecting partial-thickness tears of the rotator cuff

Brockmeyer, Matthias; Schmitt, Cornelia; Haupert, Alexander; Kohn, Dieter; Lorbach, Olaf

doi:10.1007/s00402-017-2799-3

Cited by 37 publications

(40 citation statements)

References 11 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Particularly in case of tears with frayed margins, this may simply not be possible (evaluation of the margins of the tears would have required arthroscopic inspection, which was not covered by the study protocol). Third, in patients with PTRCT there is poor association between subject symptoms and degree of structural integrity of the rotator cuff [36,37]. Accordingly, clinical improvement appears much more relevant than disappearance of PTRCT on MRI scans in treatment of sPTRCT, and the latter was achieved in this study using UA-ADRCs.…”

Section: Efficacy Of Treating Symptomatic Partial-thickness Rotator mentioning

confidence: 65%

Safety and Efficacy of Treating Symptomatic, Partial-Thickness Rotator Cuff Tear with Fresh, Uncultured, Unmodified, Autologous Adipose Derived Regenerative Cells (UA-ADRCs) Isolated at Point of Care: A Prospective, Randomized, Controlled First-in-Human Pilot Study

Hurd¹,

Facile²,

Weiss³

et al. 2019

Preprint

View full text Add to dashboard Cite

Background: This study tested the hypothesis that treatment of symptomatic, partial-thickness rotator cuff tear (sPTRCT) with fresh, uncultured, unmodified, autologous adipose derived regenerative cells (UA-ADRCs) isolated from lipoaspirate at point of care is safe and more effective than corticosteroid injection. Methods: Subjects aged between 30 and 75 years with sPTRCT who did not respond to traditional nonoperative care for at least six weeks were randomly assigned to receive a single injection of an average 11.4×106 UA-ADRCs (in 5 ml liquid; mean cell viability: 88%) (n=11; modified intention-to-treat (mITT) population) or a single injection of 80 mg of methylprednisolone (40 mg/ml; 2 ml) plus 3 ml of 0.25% bupivacaine (n=5; mITT population), respectively. Safety and efficacy were assessed using the American Shoulder and Elbow Surgeons Standardized Shoulder Assessment Form (ASES), RAND Short Form-36 Health Survey and pain visual analogue scale (VAS) at baseline (BL) as well as 3 weeks (W3), W6, W9, W12, W24, W32, W40 and W52 post treatment. Fat-saturated T2 weighted magnetic resonance imaging of the shoulder was performed at BL as well as at W24 and W52 post treatment. Results: No severe adverse events related to the injection of UA-ADRCs were observed in the twelve months post treatment. The risks connected with treatment of sPTRCT with UA-ADRCs were not greater than those connected with treatment of sPTRCT with corticosteroid injection. Subjects in the UA-ADRCs group showed statistically significantly higher mean ASES total scores at W24 and W52 post treatment than subjects in the corticosteroid group (p < 0.05). Discussion: Injection of fresh, uncultured, unmodified, autologous adipose derived regenerative cells is a safe and effective treatment of sPTRCT. Larger trials are needed to verify this result. Trial registration: Clinicaltrials.gov ID NCT02918136. Registered September 28, 2016. Level of evidence: Level I; prospective, randomized, controlled trial.

show abstract

Section: Efficacy Of Treating Symptomatic Partial-thickness Rotator mentioning

confidence: 65%

Safety and Efficacy of Treating Symptomatic, Partial-Thickness Rotator Cuff Tear with Fresh, Uncultured, Unmodified, Autologous Adipose Derived Regenerative Cells (UA-ADRCs) Isolated at Point of Care: A Prospective, Randomized, Controlled First-in-Human Pilot Study

Hurd¹,

Facile²,

Weiss³

et al. 2019

Preprint

View full text Add to dashboard Cite

show abstract

“…M. Brockmayer с соавторами в своем исследовании пришли к выводу, что комбинация тестов с проведением МРТ не увеличивает чувствительность [26]. Однако полученные нами данные показывают, что МРТ-исследование в сочетании с проведением тестов позволяет достичь максимальной чувствительности.…”

Section: Discussionunclassified

Features of Partial Rotator Cuff Tears Diagnostics

Logvinov

Ilyin²,

Ильин³

et al. 2019

Traumatology and Orthopedics of Russia

View full text Add to dashboard Cite

Partial rotator cuff tears are the most common pathology of the shoulder joint. Diagnostic of such conditions is a challenging problem for trauma surgeon.Purpose of the study is to analyze the diagnostic significance of manual tests and the standard MRI of the shoulder joint.Materials and Methods. The study is a retrospective analysis of disease history data of 25 patients (15 males, 10 females) treated at the authors’ hospital during the period from 2014 to 2017. Examination was performed according to a standard protocol: assessment of shoulder range of motion, palpation, manual examination, including “full/empty can” test, a painful arc symptom and the Hawkins – Kennedy test. All patients underwent MRI of the shoulder joint. The mean age of patients was 50.8 years. Shoulder joint arthroscopic inspection was considered the gold standard for diagnostics.Results. After data analysis, the following results were obtained: sensitivity of the “full can” test was 68%, the accuracy was 68%; “empty can” test sensitivity and accuracy were 76%, respectively. MRI sensitivity for diagnostics of supraspinatus tendon ruptures was 84% with the accuracy of 84%. The combination of the Hawkins – Kennedy test with the symptom of painful arch demonstrated accuracy and sensitivity of 64%. The study evaluated the effectiveness of MRI for diagnostic of the rupture type: sensitivity for injury from the joint surface — 80%, from the subacromial space — 70%; specificity for ruptures from the articular surface — 90% and from the subacromial space — 93%. The accuracy was 84% for both types of ruptures.Conclusions. Combined application of manual tests and MRI of the shoulder joint allows to diagnose partial rotator cuff tears in the majority of cases.

show abstract

“…The diagnostic accuracy of MRI is not completely reliable for partial-thickness rotator cuff tears [11]. For partialthickness tears, MRI and ultrasonography both have poor sensitivity (74 and 52%, respectively).…”

Section: Imagingmentioning

confidence: 98%

“…For full-thickness tears, MRI and ultrasound have excellent diagnostic accuracy (sensitivities of 94 and 92%, respectively, specificity of 93%) [12]. Dynamic ultrasound (real-time imaging during movement of the body part being imaged) may improve the diagnostic accuracy when used in conjunction with MRI for partialthickness tears [11]. It is important to note that ultrasonography has the limitations of being operator-dependent and the variability of ultrasound interpretation training [5].…”

Section: Imagingmentioning

confidence: 99%

Evaluation and Management of Rotator Cuff Tears: a Primary Care Perspective

Mathiasen

Hogrefe

2018

Curr Rev Musculoskelet Med

View full text Add to dashboard Cite

In the primary care setting, rotator cuff pathology is commonly encountered. Information regarding the risks of oral medications for the management of the associated pain keeps mounting. Partial-thickness rotator cuff tears remain difficult to diagnose with a single imaging modality. Musculoskeletal education in medical schools and non-orthopaedic residency and fellowship training programs continues to be an area for additional improvement. In the primary care office, the initial evaluation of shoulder pain should include a thorough musculoskeletal evaluation in order to identify the source of the pain (e.g., shoulder, cervical spine, chest wall), as well as the development of an initial treatment plan. Access to imaging modalities such as ultrasound and MRI can vary depending on the resources available in the primary care setting. The identification of patients who may benefit from early surgical referral is imperative for optimizing outcomes.

show abstract

Limited diagnostic accuracy of magnetic resonance imaging and clinical tests for detecting partial-thickness tears of the rotator cuff

Abstract: Level II, Diagnostic study.

Cited by 37 publications

References 11 publications

Safety and Efficacy of Treating Symptomatic, Partial-Thickness Rotator Cuff Tear with Fresh, Uncultured, Unmodified, Autologous Adipose Derived Regenerative Cells (UA-ADRCs) Isolated at Point of Care: A Prospective, Randomized, Controlled First-in-Human Pilot Study

Safety and Efficacy of Treating Symptomatic, Partial-Thickness Rotator Cuff Tear with Fresh, Uncultured, Unmodified, Autologous Adipose Derived Regenerative Cells (UA-ADRCs) Isolated at Point of Care: A Prospective, Randomized, Controlled First-in-Human Pilot Study

Features of Partial Rotator Cuff Tears Diagnostics

Evaluation and Management of Rotator Cuff Tears: a Primary Care Perspective

Contact Info

Product

Resources

About