The diagnostic accuracy of acetabular labral tears using magnetic resonance imaging and magnetic resonance arthrography: a meta-analysis

Smith, Toby; Hilton, Gemma; Toms, Andoni P.; Donell, Simon T.; Hing, Caroline B.

doi:10.1007/s00330-010-1956-7

Cited by 173 publications

(99 citation statements)

References 53 publications

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“…However, although several studies have reported a higher accuracy for MR arthrography in the detection of chondrolabral lesions [17,30,31], the use of intraarticular contrast might not be logistically feasible in a larger study trial and/or in clinical [32], and, more importantly, for the majority of these studies, a 1.5-T MRI system was used. In this context, recent studies have shown that the use of a high-resolution, nonarthrographic 3-T MRI is capable of detecting chondral and labral abnormalities with high accuracy [20,33,34] and therefore may obviate the need for intraarticular contrast.…”

Section: Discussionmentioning

confidence: 99%

Validation of scoring hip osteoarthritis with MRI (SHOMRI) scores using hip arthroscopy as a standard of reference

et al. 2018

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Purpose To validate SHOMRI gradings in preoperative hip magnetic resonance imaging (MRI) with intra-arthroscopic evaluation of intraarticular hip abnormalities. Methods Preoperative non-arthrographic 3.0-T MRIs of 40 hips in 39 patients (1 patient with bilateral hip surgery) with femoroacetabular impingement (FAI) syndrome (mean age, 34.7 years ± 9.0; n = 16 females), refractory to conservative measures, that underwent hip arthroscopy were retrospectively assessed by two radiologists for chondrolabral abnormalities and compared with intra-arthroscopic findings as the standard of reference. Arthroscopically accessible regions were compared with the corresponding SHOMRI subregions and assessed for the presence and grade of cartilaginous pathologies in the acetabulum and femoral head. The acetabular labrum was assessed for the presence or absence of labral tears. For the statistical analysis sensitivity and specificity as well as intraclass correlation (ICC) for interobserver agreement were calculated. Results Regarding chondral abnormalities, 58.8% of the surgical cases showed chondral defects. SHOMRI scoring showed a sensitivity of 95.7% and specificity of 84.8% in detecting cartilage lesions. Moreover, all cases with fullthickness defects (n = 9) were identified correctly, and in n = 6 cases (out of n = 36 with partial-thickness defects) the defective cartilage was identified but the actual depth overestimated. Labral tears were present in all cases and the MR readers identified 92.5% correctly. ICC showed a good interobserver agreement with 86.3% (95% CI 80.0, 90.6%) Conclusion Using arthroscopic correlation, SHOMRI grading of the hip proves to be a reliable and precise method to assess chondrolabral hip joint abnormalities. Key Points • Assessment of hip abnormalities using MRI with surgical correlation.• Comparing surgery and MRI by creating a hybrid anatomic map that covers both modalities.• Non-arthrographic use of 3.0-T MRI provides detailed information on cartilage and labral abnormalities in hip joints.

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Section: Discussionmentioning

confidence: 99%

Validation of scoring hip osteoarthritis with MRI (SHOMRI) scores using hip arthroscopy as a standard of reference

et al. 2018

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“…The most recent studies find that MRA has a sensitivity of 93 -100 percent and an accuracy of 93-96 percent [30][31][32]. Metaanalysis supports the superior reliability of MRA to plain MRI, although variability and the use of small datasets were noted [33]. The accuracy of MRA may be dependent on training: for both MRA and plain MRI, the accuracy of labral tear diagnosis was 85 percent for musculoskeletal radiologists and 70 percent for general radiologists [34].…”

Section: Diagnosis and Clinical Presentation Of Labral Tearsmentioning

confidence: 95%

Regenerative Injection Therapy (Prolotherapy) for Hip Labrum Lesions: Rationale and Retrospective Study

Hauser

Orlofsky²

2013

TOREHJ

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Abstract:Background: Acetabular labral tear is a debilitating condition for which there are few effective non-surgical treatment options. A number of studies in humans and in animal models suggest that the labrum may have a capacity for spontaneous healing, and that therapies that seek to exploit and facilitate this process may be beneficial. Regenerative injection therapies have shown promise in the treatment of several musculoskeletal disorders, but have not previously been applied to labral tear. Methods:We present an initial case series of 19 patients with labral tear that were treated in our clinic with intra-articular injections of hypertonic dextrose. Patient-reported assessments were collected by questionnaire between 1 and 60 months post-treatment (mean = 12 months).Results: All patients reported improvements in pain relief and functionality. Patients reported complete relief of 54% of recorded symptoms. Improvements did not show dependence on the time between treatment and follow-up. No adverse events were reported. Conclusions:Regenerative injection therapy (prolotherapy) for acetabular labral tear appears to be a safe and potentially efficacious procedure that merits further investigation as a non-surgical option.

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“…There has been considerable variation among studies evaluating the utility of conventional MRI to detect labral tears. A recent meta-analysis, which included 19 studies reported a pooled sensitivity of 0.66 (95% CI: 0.59 to 0.73) and a pooled specificity of 0.79 (95% CI: 0.67 to 0.91) [18]. The same meta-analysis also compared 15 studies evaluating the test characteristics for MRA.…”

Section: Issn: 2470-9824mentioning

confidence: 96%

“…The pooled sensitivity for MRA was 0.87 (95% CI: 0.84 to 0.90) and pooled specificity was 0.64 (95% CI: 0.54 to 0.74). Interestingly, conventional MRI had a higher specificity than MRA, but MRA's higher ROC curve indicated superior overall diagnostic accuracy [18]. MRA is also superior to conventional MRI for the diagnosis of other subtle intra-articular A B Figure 5: Twenty-year-old female ballet dancer with left hip pain for one month and discordant US and MRA findings of labral tear.…”

Section: Issn: 2470-9824mentioning

confidence: 99%

“…The goals of evaluating the patient with hip pain include confirmation of the intra-articular etiology and characterization of associated structural abnormalities in order to customize treatment [17]. Acetabular labral tears typically occur through one of five mechanisms: Trauma, femoroacetabular impingement, capsular laxity/hip hypermobility, hip dysplasia, and degeneration [5,14,15,18,19]. While 90% of patients diagnosed with acetabular labral tears complain of dull anterior hip or groin pain, other symptoms may include hip clicking, locking, or instability [2,5,17,20,21].…”

Section: Issn: 2470-9824mentioning

confidence: 99%

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Sonoarthrography of the Hip Labrum: Ultrasound Evaluation of the Anterosuperior Acetabular Labrum Following Joint Distension with Magnetic Resonance Arthrographic Correlation

Stone¹,

Long²,

Petchprapa³

et al. 2016

J Orth Rhe Sp Med

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Objective: To determine if the anterosuperior labrum can be accurately evaluated by ultrasound after an intra-articular injection, comparing it to same-day magnetic resonance arthrography. Methods:This retrospective study included patients referred for ultrasound-guided hip magnetic resonance arthrogram injections. Following injection, patients received ultrasound evaluation of the anterosuperior labrum. Images were retrospectively reviewed. The labrum was evaluated below the rectus femoris, between the rectus femoris and iliopsoas, and below the iliopsoas. In each location, presence or absence of abnormal morphology, labral clefts, or chondrolabral clefts was recorded. Arthroscopy reports were correlated when available.Results: Twenty six patients received same day injection and magnetic resonance arthrogram. Six patients had arthroscopy. Ultrasound and magnetic resonance arthrogram correlated in 53% of points. When each labrum was divided into three zones, ultrasound demonstrated sensitivity of 0.868 and specificity of 0.160 for labral pathology. Ultrasound showed pathology in all patients below the rectus femoris, and between the rectus femoris and iliopsoas tendons. When limiting evaluation to below the iliopsoas tendon, ultrasound had sensitivity and specificity for labral pathology of 0.650 and 0.667. For labral clefts, ultrasound had sensitivity and specificity of 0.741 and 0.451. For chondrolabral junction clefts, ultrasound reported sensitivity and specificity of 0.578 and 0.303 respectively. For abnormal pathology, ultrasound had sensitivity and specificity of 0.810 and 0.491 respectively. Conclusions:"Sonoarthrography" appears to be a sensitive examination for detecting labral substance tears and abnormal labral morphology. Post-injection ultrasound adds approximately three minutes to the examination and may supply additional useful diagnostic information.

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The diagnostic accuracy of acetabular labral tears using magnetic resonance imaging and magnetic resonance arthrography: a meta-analysis

Abstract: MRI and MRA may be useful adjuncts in the diagnosis of acetabular labral tears in adults. MRA appears to be superior to conventional MRI.

Cited by 173 publications

References 53 publications

Validation of scoring hip osteoarthritis with MRI (SHOMRI) scores using hip arthroscopy as a standard of reference

Validation of scoring hip osteoarthritis with MRI (SHOMRI) scores using hip arthroscopy as a standard of reference

Regenerative Injection Therapy (Prolotherapy) for Hip Labrum Lesions: Rationale and Retrospective Study

Sonoarthrography of the Hip Labrum: Ultrasound Evaluation of the Anterosuperior Acetabular Labrum Following Joint Distension with Magnetic Resonance Arthrographic Correlation

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