Accuracy of magnetic resonance imaging to diagnose superior labrum anterior–posterior tears

Abstract

In our retrospective study of 444 patients, sensitivity, specificity, and accuracy were all lower than previously reported in the literature for diagnosing SLAP lesions. Our data indicated that while MRI could exclude a SLAP lesion (NPV = 95 %), MRI alone was not an accurate clinical tool. MR arthrography had a large number of false-positive readings in this study. We concluded that even with intra-articular contrast, MRI had limitations in the ability to diagnose surgically proven SLAP lesions.

Imaging modality for measuring the presence and extent of the labral lesions of the shoulder: a systematic review and meta-analysis

“…Subsequently, further exclusions were performed by downloading and reviewing the full-text versions of the remaining studies. After a detailed search and selection process, 14 studies [15,17,22,23,[31][32][33][34][35][36][37][38][39][40] involving 1216 patients with labral lesions met the inclusion criteria for the meta-analysis. Table 1 and Table 2 present the main characteristics of the participants and the included studies.…”

“…Recently, multiple high-quality studies [14,[21][22][23] were published, most of which used relatively high resolution for CTA and relatively high-field strength magnets and multidimensional imaging for MRI and MRA. Moreover, no studies have compared the diagnostic performance of MRI, D-MRA, I-MRA and CTA using side-by-side analysis in a single study for the detection of labral lesions.…”

Upper Extremity Injuries in Tennis Players

“…71 MR imaging has also proven to be a useful modality to rule out the diagnosis of a SLAP lesion, but is not an accurate clinical diagnostic tool when utilized alone. 72 …”

The Snyder Classification of Superior Labrum Anterior and Posterior (SLAP) Lesions

“…Given the difficulties in reliably classifying SLAP lesions based on arthroscopic videos [8], it is not surprising that physical examination maneuvers [5,18] and MRI findings [21] are reported to be unreliable in correctly diagnosing SLAP lesions. In two systematic reviews of physical examination reliability and validity for diagnostic accuracy of SLAP tears [5,12], the methodologically robust studies determined that Speed's and Yergason's tests (among all maneuvers) showed sensitivity of 32% and 43% and specificity of 79% and 75%, respectively [5,12].…”

“…The confidence interval for likelihood ratios all included 1.0, indicating that Speed's and Yergason's tests could not rule in or rule out a SLAP lesion in comparison to arthroscopy [12]. Studies investigating MRI and MR arthrography in diagnosing SLAP tears have reported sensitivity and specificity ranging from 66% to 98% and 13% to 89%, respectively [6,7,9,20,21,23]. Variation in study design, MRI methods, and lack of reliability among observers likely accounts for such a wide discrepancy [16].…”