Shoulder MRI accuracy in the community setting

Houtz, Carlton G.; Schwartzberg, Randy; Barry, Jason A.; Reuss, Bryan L.; Papa, Linda

doi:10.1016/j.jse.2011.01.003

Cited by 22 publications

(15 citation statements)

References 32 publications

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“…Stage 1 was assigned if no proximal migration could be detected, stage 2 consisted of mild proximal migration characterized by interruption of the so-called Maloney line of the shoulder, and stage 3 consisted of severe proximal migration characterized by obliteration of the subacromial space and sclerosis of the undersurface of the acromion 10,11 . MRI was performed preoperatively to evaluate the rotator cuff tendon tear and muscle quality 22,23 .…”

Section: Imaging Assessmentmentioning

confidence: 99%

Arthroscopic-Assisted Latissimus Dorsi Transfer for the Management of Irreparable Rotator Cuff Tears

Castricini

Longo

Benedetto

et al. 2014

The Journal of Bone and Joint Surgery

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Section: Imaging Assessmentmentioning

confidence: 99%

Arthroscopic-Assisted Latissimus Dorsi Transfer for the Management of Irreparable Rotator Cuff Tears

Castricini

Longo

Benedetto

et al. 2014

The Journal of Bone and Joint Surgery

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mentioning

confidence: 99%

“…2,4,14,17,34,35 However, other studies have demonstrated that noncontrast MRI and MR arthrography are neither highly sensitive nor specific for the diagnosis of superior labral anterior posterior (SLAP) lesions. 1,3,7,15,26,28 Initially thought to be an uncommon entity, the incidence of SLAP lesion surgery has increased in the United States in the past decade. 23,34,36,38 Such studies have demonstrated that a significant contingent of patients undergoing SLAP lesion surgeries were middle-aged.…”

mentioning

confidence: 99%

High Prevalence of Superior Labral Tears Diagnosed by MRI in Middle-Aged Patients With Asymptomatic Shoulders

Schwartzberg

Reuss

Burkhart

et al. 2016

Orthopaedic Journal of Sports Medicine

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Background:The incidence of superior labral surgery has increased in the past decade in the United States, and a contributing factor could be an increased rate of superior labral tears diagnosed with magnetic resonance imaging (MRI). Prior MRI studies of the asymptomatic shoulder have focused on rotator cuff pathology or pathology in a narrow and specific group of athletes. Labral abnormalities have not previously been thoroughly evaluated in asymptomatic middle-aged individuals.Purpose:To evaluate the prevalence of superior labral tears diagnosed by MRI in the asymptomatic shoulders of middle-aged people (age range, 45-60 years).Study Design:Cross-sectional study; Level of evidence, 3.Methods:A total of 53 asymptomatic adults (age range, 45-60 years) with no history of surgery or injury to either shoulder were included in the study. Physical examinations of all shoulders were performed. Noncontrast MRI (1.5 T) was performed in 1 randomly determined shoulder of each subject. Two fellowship-trained musculoskeletal radiologists who were blinded to the purpose of the study and ages of the subjects evaluated each MRI.Results:Radiologists interpreted the MRIs as consistent with superior labral tears in 55% and 72% of the cohort. Comparison of the radiological evaluations of the superior labra were moderate (κ = 0.410, P = .033). There were no differences in readings for superior labral tear regarding age (P = .87), sex (P = .41), whether the dominant shoulder underwent MRI (P = .99), whether the subject worked a physical job (P = .08), or whether the subject participated in overhead sports for a period of 1 year (P = .62).Conclusion:Superior labral tears are diagnosed with high frequency using MRI in 45- to 60-year-old individuals with asymptomatic shoulders. These shoulder MRI findings in middle-aged populations emphasize the need for supporting clinical judgment when making treatment decisions for this patient population.Clinical Relevance:To avoid overtreatment, physicians should realize that superior labral tears diagnosed by MRI in individuals between the ages of 45 and 60 years may be normal age-related findings.

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“…There appears to be an agreement among studies reporting lower sensitivity and higher specificity of MRI in detecting pathologies of the long head of the biceps. 7 In their study, Houtz et al 10 observed low sensitivity, which ranged from 7% to 33%, versus specificity values ranging from 95% to 100% in the 31 cases of alterations of the long head of the biceps out of 104 cases evaluated by MRI without contrast, regardless of the radiologists’ place of work (community vs . academia).…”

Section: Discussionmentioning

confidence: 93%

“…Another issue is the fact that the scans were interpreted by radiologists from the community, who were not necessarily trained to interpret musculoskeletal MRIs; nonetheless, some studies have failed to identify differences in MRI interpretation by academic and community radiologists. 10 As a positive aspect, this study had a significant sample of 965 patients; to the best of the authors’ knowledge, that is the largest sample in the subject. 1 , 2 , 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 …”

Section: Discussionmentioning

confidence: 99%

Magnetic resonance imaging without contrast as a diagnostic method for partial injury of the long head of the biceps tendon

Nascimento¹,

Claudio²

2017

Revista Brasileira de Ortopedia (English Edition)

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ObjectiveTo evaluate the use of magnetic resonance imaging (MRI) without contrast as a diagnostic method of partial lesions of the long head of the biceps, using arthroscopic surgery as the gold standard.MethodsWe evaluated data from MRI and arthroscopic surgical findings of patients operated due to rotator cuff and SLAP injuries. MRI without contrast of at least 1.5 T, with a radiologist report, was used as a criterion for the detection of long head of the biceps injury. All cases were operated by the same surgeon at this hospital.ResultsThis study evaluated data from 965 patients, 311 women (32%) and 654 men (68%), with a mean age of 45 years, who underwent arthroscopic surgery for rotator cuff and SLAP repair from September 2012 to September 2015. Overall, the sensitivity and specificity of MRI was 0.22 (CI: 0.17–0.26) and 0.98 (CI: 0.96–0.99), respectively.ConclusionsMRI has a low sensitivity and high specificity for detection of partial tears of the long head of the biceps tendon.

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Shoulder MRI accuracy in the community setting

Cited by 22 publications

References 32 publications

Arthroscopic-Assisted Latissimus Dorsi Transfer for the Management of Irreparable Rotator Cuff Tears

Arthroscopic-Assisted Latissimus Dorsi Transfer for the Management of Irreparable Rotator Cuff Tears

High Prevalence of Superior Labral Tears Diagnosed by MRI in Middle-Aged Patients With Asymptomatic Shoulders

Magnetic resonance imaging without contrast as a diagnostic method for partial injury of the long head of the biceps tendon

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