The broken circle method: a novel technique that enhances detection of Hill–Sachs lesions on internal rotation shoulder radiographs

Yu, Joseph S.; Rink, Trenton; Yu, Sisheng; Liu, K.; Carver, Keith C.; Lather, Jason D.; Payne, Jason E.; Rogers, Alexander; Erdal, Barbaros S.

doi:10.1016/j.crad.2020.09.006

Cited by 3 publications

(8 citation statements)

References 45 publications

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“…Once a shoulder dislocates, there is increased potential for dislocation to happen again. The most significant risk factors for recurrence are the age that the initial dislocation took place and the gender of the patient [7]. Patients who have a dislocation before the age of 20 years have a 5-fold greater risk of redislocating the same shoulder compared to those over 40 years old.…”

Section: Anterior Shoulder Dislocationsmentioning

confidence: 99%

“…With each recurrence, the joint becomes increasingly unstable. This cumulative effect occurs because repeat dislocations have higher rates of injury to the inferior labroligamentous complex, the capsule, and the osseous structures that serve as stabilizers of the shoulder [7].…”

Section: Anterior Shoulder Dislocationsmentioning

confidence: 99%

“…Hill-Sachs lesions involving greater than 40% of the humeral head are nearly always clinically significant, associated with greater joint instability, heightened risk of recurrence, and increased likelihood for surgical treatment [3]. A new detection method, referred to as the Broken Circle sign, has recently reported sensitivity of 91% and specificity of 82% for Hill-Sachs lesions of any size [7]. This technique makes use of the markup region of interest (ROI) function within the picture archive and communication system (PACS).…”

Section: Hill-sachs Lesionmentioning

confidence: 99%

“…This technique enables detection of even subtle deviations from the reference circle, often seen with small or shallow defects when the vertical condensation line is absent. The Broken Circle detection method has been shown to improve reader accuracy and sensitivity without dramatically altering specificity [7].…”

Section: Hill-sachs Lesionmentioning

confidence: 99%

“…Adequate rotation is confirmed when the lateral margin of the intertubercular groove is medial to the long axis reference line (arrow); (b) When a Hill-Sachs impaction defect occurs in the 10 or 11 o'clock zones, it is a positive sign (1 or 2 o'clock in the opposite shoulder). [Used with permission from Yu JS, et al[7]].…”

mentioning

confidence: 99%

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Shoulder Dislocations: A Dedicated Search Strategy for Important Radiographic Signs

2021

Sports Injr Med

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Purpose of Review:The glenohumeral (GH) joint is the most commonly dislocated joint in the human body. In acute dislocations, radiographs remain the first line of study. Despite their frequency, important secondary signs of anterior dislocation (such as impaction defects of the humeral head and glenoid rim fractures) are often subtle and easily missed.Recent Findings: By using a dedicated search strategy, one that applies a comprehensive search for impaction defects at vulnerable sites, glenoid rim fractures, and changes in alignment, one may maximize the diagnostic accuracy of radiographic interpretation.

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Section: Anterior Shoulder Dislocationsmentioning

confidence: 99%

Section: Anterior Shoulder Dislocationsmentioning

confidence: 99%

Section: Hill-sachs Lesionmentioning

confidence: 99%

Section: Hill-sachs Lesionmentioning

confidence: 99%

mentioning

confidence: 99%

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Shoulder Dislocations: A Dedicated Search Strategy for Important Radiographic Signs

2021

Sports Injr Med

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With the exception of the Hill–Sachs interval, CT and MRI show no significant differences in the diagnostic value of the HSL measurement regardless of the measurement technique

Sgroi

Huzurudin

Ludwig

et al. 2021

Knee Surg Sports Traumatol Arthrosc

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PurposeThe aim of the current study was to compare the diagnostic precision and reliability of different methods in measuring Hill–Sachs lesions (HSLs) using MRI and CT. MethodsA total of 80 consecutive patients with a history of anterior shoulder instability were retrospectively included. The preoperative CT and MRI scans of the affected shoulders were analysed. To investigate the ability of the Franceschi grading, Calandra classification, Richards, Hall, and Rowe grading scale, Flatow percentage and “glenoid track” assessment according to Di Giacomo et al. to quantify the extent of humeral bone loss, the results of each measurement method obtained with MRI were compared with those achieved with CT. In addition, the intra‐ and inter‐rater reliabilities of each measurement method using CT and MRI were calculated and compared. ResultsA significant difference was found between CT and MRI in the determination of the Hill–Sachs interval (HSI) (p = 0.016), but not between the results of any of the other measurement techniques. With the exceptions of the Franceschi grade and Calandra classification, all measurement methods showed good or excellent intra‐ and inter‐rater reliabilities for both MRI and CT. ConclusionsWhile the determination of the HSI with MRI was more accurate, all other analysed techniques for measuring the amount of humeral bone loss showed similar diagnostic precision. With regard to the intra‐ and inter‐rater reliabilities, all measurement techniques analysed, with the exception of the Franceschi and Calandra classifications, provided good to very good reliabilities with both CT and MRI. Level of evidenceIII

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Variability in quantifying the Hill-Sachs lesion: A scoping review

et al. 2022

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Background Currently, is there no consensus on a widely accepted measurement technique for calculating the Hill-Sachs lesion (HSL). The purpose of this review is to provide an overview of the techniques and imaging modalities to assess the HSL pre-operatively. Methods Four online databases (PubMed, Embase, MEDLINE, and COCHRANE) were searched for literature on the various modalities and measurement techniques used for quantifying HSLs, from data inception to 20 November 2021. The Methodological Index for Non-Randomized Studies tool was used to assess study quality. Results Forty-five studies encompassing 3413 patients were included in this review. MRA and MRI showed the highest sensitivity, specificity, and accuracy values. Intrarater and interrater agreement was shown to be the highest amongst MRA. The most common reference tests for measuring the HSL were arthroscopy, radiography, arthro-CT, and surgical techniques. Conclusion MRA and MRI are reliable imaging modalities with good test diagnostic properties for assessment of HSLs. There is a wide variety of measurement techniques and imaging modalities for HSL assessment, however a lack of comparative studies exists. Thus, it is not possible to comment on the superiority of one technique over another. Future studies comparing imaging modalities and measurement techniques are needed that incorporate a cost-benefit analysis.

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The broken circle method: a novel technique that enhances detection of Hill–Sachs lesions on internal rotation shoulder radiographs

Cited by 3 publications

References 45 publications

Shoulder Dislocations: A Dedicated Search Strategy for Important Radiographic Signs

Shoulder Dislocations: A Dedicated Search Strategy for Important Radiographic Signs

With the exception of the Hill–Sachs interval, CT and MRI show no significant differences in the diagnostic value of the HSL measurement regardless of the measurement technique

Variability in quantifying the Hill-Sachs lesion: A scoping review

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