Trends in the treatment of proximal humerus fractures in the United States Medicare population

Christensen, Garrett V.; O’Reilly, Olivia C.; Bozoghlian, Maria F.; An, Qiang; Nepola, James V.; Patterson, Brendan M.

doi:10.1053/j.sart.2022.12.007

Cited by 1 publication

(2 citation statements)

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“…The rate of shoulder arthroplasty has increased significantly in recent decades and is projected to increase further [ 7 , 22 - 24 ]. This increase in shoulder arthroplasty has also contributed to multiple innovations, such as preoperative planning software and patient-specific implants and instrumentation [ 25 , 26 ].…”

Section: Discussionmentioning

confidence: 99%

“…Incidental findings commonly are reported by the reading radiologist in the final report. Improvements in resolution quality, coupled with the growing number of shoulder arthroplasty procedures performed every year in the United States [ 5 - 7 ], will likely contribute to an increased number of incidental findings. This poses a very specific challenge to surgeons, as they attempt to counsel patients on findings that may be unrelated to the underlying indication for a given imaging study.…”

Section: Introductionmentioning

confidence: 99%

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Rate of incidental findings on routine preoperative computed tomography for shoulder arthroplasty

Meeker,

Bozoghlian,

Hartog

et al. 2024

Clin Shoulder Elb

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Background: Incidental findings are commonly noted in advanced imaging studies. Few data exist regarding the rate of incidental findings on computed tomography (CT) for preoperative shoulder arthroplasty planning. This study aims to identify the incidence of these findings and the rate at which they warrant further work-up to help guide orthopedic surgeons in counseling patients.Methods: A retrospective review was performed to identify patients with available preoperative shoulder CT who subsequently underwent shoulder arthroplasty procedures at a single institution between 2015 and 2021. Data including age, sex, and smoking status were obtained. Radiology reports for CTs were reviewed for incidental findings and categorized based on location, tissue type, and/or body system. The rate of incidental findings and the rate at which further follow-up was recommended by the radiologist were determined.Results: A total of 617 patients was identified. There were 173 incidental findings noted in 146 of these patients (23.7%). Findings ranged from pulmonary (59%), skin/soft tissue (16%), thyroid (13%), vascular (9%), spinal (2%), and abdominal (1%) areas. Of the pulmonary findings, 50% were pulmonary nodules and 47% were granulomatous disease. Overall, the final radiology report recommended further follow-up for 50% of the patients with incidental findings.Conclusions: Incidental findings are relatively common in preoperative CTs obtained for shoulder arthroplasty, occurring in nearly one-quarter of patients. Most of these findings are pulmonary in nature. Overall, half of the patients with incidental findings were recommended for further follow-up. These results establish population data to guide orthopedic surgeons in patient counseling.Level of evidence: III.

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