Magnetic Resonance Imaging of the Asymptomatic Shoulder of Overhead Athletes

Connor, Patrick M.; Banks, David M.; Tyson, Alan B; Coumas, James M.; D’Alessandro, Donald F

doi:10.1177/03635465030310051501

Cited by 232 publications

(135 citation statements)

References 10 publications

(17 reference statements)

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“…The mean (range) score was 48% 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67 for cohort, 41% 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41...…”

Section: Resultsmentioning

confidence: 99%

What Imaging‐Detected Pathologies Are Associated With Shoulder Symptoms and Their Persistence? A Systematic Literature Review

Tran

Cowling

Smith

et al. 2018

Arthritis Care & Research

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ObjectiveShoulder symptoms are common, and imaging is being increasingly used to help with management. However, the relationship between imaging and symptoms remains unclear. This review aims to understand the relationship between imaging‐detected pathologies, symptoms, and their persistence.MethodsA systematic review using Medline, EMBASE, Cochrane, and grey literature was conducted to April 2017. The cross‐sectional and longitudinal relationships between imaging‐detected abnormalities and symptoms were analyzed and associations qualitatively characterized by a best‐evidence synthesis based on study design, covariate adjustment, and the Grade of Recommendations Assessment, Development, and Evaluation (GRADE) methodology. Modalities included ultrasound, magnetic resonance imaging (MRI), radiographs, positron emission tomography (PET), bone scintigraphy, and computed tomography.ResultsA total of 6,569 abstracts was screened and 56 articles were included. In total, 50 studies did not adjust for covariates and 36 analyzed individual pathologies only. The majority of studies showed conflicting results. There was no significant association between most imaging features and symptoms among high‐quality, cross‐sectional studies. There was low‐quality evidence that enhancement of the joint capsule on MRI and increased uptake on PET were associated with symptoms in adhesive capsulitis. Based on high‐quality longitudinal studies, enlarging rotator cuff tears were associated with an increased incidence of symptoms.ConclusionThere were conflicting results on the association of imaging features with shoulder symptoms and their persistence. The existing evidence was very low in quality, based on the GRADE methodology. Further high‐quality studies are required to understand the relationship between imaging and shoulder symptoms and to determine the appropriate role of imaging in care pathways.

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Section: Resultsmentioning

confidence: 99%

What Imaging‐Detected Pathologies Are Associated With Shoulder Symptoms and Their Persistence? A Systematic Literature Review

Tran

Cowling

Smith

et al. 2018

Arthritis Care & Research

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“…Since the clinical differentiation between tendinopathy, partial tears and acute tendinitis is difficult, imaging is necessary for the diagnosis. The imaging modalities most commonly used are ultrasonography (US) and magnetic resonance imaging (MRI) [8][9][10][11].…”

Section: Introductionmentioning

confidence: 99%

Sonoelastography findings of supraspinatus tendon in rotator cuff tendinopathy without tear: comparison with magnetic resonance images and conventional ultrasonography

2014

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Background and purpose Sonoelastography (SE) is a new technique that can assess differences in tissue stiffness. This study investigated the performance of SE for the differentiation of supraspinatus (SSP) tendon alterations of tendinopathy compared to magnetic resonance imaging (MRI) and conventional ultrasonography (US). Methods One hundred and eighteen consecutively registered patients with symptoms and MRI findings of SSP tendinopathy were assessed with US and SE. Coronal images of the SSP tendon were obtained using US and SE. Increased signal intensity on T2-weighted images in the coronal planes were graded according to the extent of the signal changes from ventral to dorsal. SE images were evaluated by reviewers using an experimentally proven color grading system. Results Using SE, 7.6 % of the SSP tendons were categorized as grade 0, 30.5 % as grade 1, 19.5 % as grade 2, and 42.4 % as grade 3. Evaluation of the interobserver reliability of the SE findings showed ''almost perfect agreement'', with a weighted kappa coefficient of 0.83. By comparing the MRI findings with the SE findings, grades of MRI and SE had a positive correlation (r = 0.829, p = \0.001). Furthermore, grades of US and SE also had a positive correlation (r = 0.723, p = \0.001). Conclusions SE is valuable in the detection of the intratendinous and peritendinous alterations of the SSP tendon and has excellent interobserver reliability and excellent correlation with MRI findings and conventional ultrasonography findings.Keywords Rotator cuff Á Tendinopathy Á Ultrasonography Á Sonoelastography Riassunto Obiettivi La sonoelastografia (SE) è una nuova tecnica in grado di valutare le differenze di rigidità dei tessuti. Questo studio ha valutato le capacità della SE nella differenziazione delle alterazioni tendinee da tendinopatia del sovraspinato (SSP) rispetto a risonanza magnetica (MRI) ed ecografia convenzionale (US). Materiali e Metodi Centoventuno pazienti con sintomi e reperti MRI di tendinopatia del SSP sono stati valutati con US e SE. Si sono realizzate immagini coronali del tendine SSP utilizzando US e SE. Sono state valutate immagini T2-pesate, per la maggiore intensità del segnale, nei piani coronali, da ventrale a dorsale. Immagini di SE sono state valutate da revisori che utilizzavano un sistema di grading di colore sperimentale. Risultati Utilizzando la SE, 7,4 % dei tendini SSP sono stati classificati come di grado 0, 29,8 % di grado 1, 19,8 % di grado 2, e 43,0 % di grado 3. La valutazione inter-osservatori dei risultati SE ha mostrato ''accordo quasi perfetto'', con un coefficiente kappa pesato di 0,83. Confrontando i risultati della risonanza magnetica con i risultati della SE, risonanza magnetica e SE hanno avuto una correlazione positiva (r = 0,849, p = \ 0.001). Inoltre, anche US e SE hanno avuto una correlazione positiva (r = 0,706, p = \ 0,001). Conclusioni La SE è valida nella rilevazione delle alterazioni intra-tendinee e peri-tendinee del tendine SSP e ha un'ottima affidabilità inter-osservatori e un'eccellente ...

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“…Although asymptomatic structural changes have been reported in a variety of body regions, to our knowledge, no prior investigation has systematically evaluated the plantar heel region in asymptomatic runners, a group at risk for developing heel abnormalities. [21][22][23][24][25][26][27][28][29][30][31][32][33][34][35] Consequently, the primary purpose of this investigation was to determine the prevalence and spectrum of asymptomatic sonographically determined structural changes in the plantar fascia and plantar heel pad among experienced runners without a history of heel pain. On the basis of our preliminary observations, we hypothesized that more than 50% of asymptomatic runners would have at least 1 structural abnormality in 1 heel, as defined by the following: (1) presence of vascularization on power Doppler sonography, (2) nonuniform heterogeneous echo texture of the plantar heel pad, (3) abnormal plantar heel pad thickness (uncompressed heel pad thickness <12 or > 28 mm), 15,36 (4) abnormal plantar heel pad compressibility (heel pad compressibility index <0.45 or >0.75), 15 (5) abnormal plantar fascia thickness (>4 mm), 1 and (6) abnormal plantar fascia echo texture.…”

mentioning

confidence: 99%

Sonographic Evaluation of the Plantar Heel in Asymptomatic Endurance Runners

Hall

Finnoff

Sayeed

et al. 2015

J of Ultrasound Medicine

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lantar heel pain is a common condition affecting endurance runners and accounts for approximately 8% of all runningrelated injuries. 1 Although plantar fasciitis is the most common cause of heel pain in the athletic population, 2,3 the differential diagnosis of heel pain is broad and includes plantar heel pad syndrome (also referred to as fat pad syndrome), calcaneal fractures, regional nerve entrapments (eg, Baxter nerve), and referred pain syndromes. 2 The role of musculoskeletal sonography in the evaluation of plantar heel pain has been well established with respect to the plantar fascia. [3][4][5][6][7][8][9][10][11][12][13][14][15] More specifically, plantar fascia thickening (>4 mm), hypoecho genicity, heterogeneity, and neovascularization are considered reliable markers of symptomatic plantar fasciitis, whereas a normalappearing plantar fascia warrants consideration of alternative causes of heel pain. 1,3,4,9,[12][13][14] On the contrary, the role of sonography Mederic M. Hall, MD, Jonathan T. Finnoff, DO, Yusef A. Sayeed, MD, MPH, MEng, Jay Smith, MD Received December 31, 2014, ORIGINAL RESEARCHObjectives-The primary purpose of this investigation was to determine the prevalence and spectrum of asymptomatic sonographically determined structural changes in the plantar fascia and plantar heel pad among experienced runners without a history of heel pain.Methods-Thirty-nine asymptomatic runners without a history of plantar heel pain were recruited. The following sonographic measures were recorded: power Doppler sonography in the plantar heel pad and plantar fascia, echo texture of the plantar heel pad, uncompressed heel pad thickness, compressed heel pad thickness, heel pad compressibility index, plantar fascia thickness, and plantar fascia echo texture. Conclusions-At least 1 potentially abnormal sonographic finding was present in each heel of all asymptomatic runners in this study. Consequently, sonographic abnormalities in the plantar heel should be interpreted within the clinical context when evaluating runners. Results-Doppler

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Magnetic Resonance Imaging of the Asymptomatic Shoulder of Overhead Athletes

Abstract: Magnetic resonance imaging alone should not be used as a basis for operative intervention in this patient population.

Cited by 232 publications

References 10 publications

What Imaging‐Detected Pathologies Are Associated With Shoulder Symptoms and Their Persistence? A Systematic Literature Review

What Imaging‐Detected Pathologies Are Associated With Shoulder Symptoms and Their Persistence? A Systematic Literature Review

Sonoelastography findings of supraspinatus tendon in rotator cuff tendinopathy without tear: comparison with magnetic resonance images and conventional ultrasonography

Sonographic Evaluation of the Plantar Heel in Asymptomatic Endurance Runners

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