Correlation of findings in clinical and high resolution ultrasonography examinations of the painful shoulder

Micheroli, Raphael; Kyburz, Diego; Ciurea, Adrian; Dubs, B; Toniolo, Martin; Bisig, Samuel Pascal; Tamborrini, Giorgio

doi:10.15557/jou.2015.0003

Cited by 24 publications

(18 citation statements)

References 35 publications

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“…In our study, we tried to explore the validity of clinical examination in the detection of US findings. The sensitivity and specificity of the supraspinatus test were 71% and 75% and this was different from Micheroli et al who reported sensitivity of 86% and specificity of 50% and this can be explained by the point that the clinical exam is operator‐dependent, can be misinterpreted from person to person according to clinical experience of the examiner and also the patient response can be misleading to the examiner.…”

Section: Discussionsupporting

confidence: 92%

Ultrasound versus magnetic resonance imaging in the evaluation of shoulder joint pathologies in a cohort of rheumatoid arthritis patients

et al. 2019

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Background: Rheumatoid arthritis (RA) is a systemic autoimmune disease that has a great impact on different joints, may result in their destruction and loss of function.Although the shoulder is affected in a large portion of patients with RA, it does not receive much attention during the follow up of RA. The precise diagnosis of shoulder pain in RA is a clinical challenge and benefits from a reliable imaging modality to detect its exact origin. Aim:To determine the diagnostic accuracy of ultrasound (US) in detecting shoulder joint pathologies in RA, considering magnetic resonance imaging (MRI) as the gold standard. Materials and Methods:This cross-sectional, observational study was carried out on 30 RA patients complaining of unilateral or bilateral shoulder pain. Patients were subjected to history taking, clinical shoulder examination, plain X-ray, US examination following a standardized protocol, and MRI. The results were correlated with each other. Results:In comparison with the MRI findings, US showed high accuracy in terms of sensitivity (Sn) and specificity (Sp) in supraspinatus tendinopathy (Sn 96.6%; Sp 93.3%), biceps tenosynovitis (Sn 87.5%; Sp 97.6%), subacromial-subdeltoid bursitis (Sn 72.7%; Sp 95.7%), humeral erosions (Sn 90.5%; Sp 97.3%), and acromioclavicular osteoarthritis (Sn 85.7%; Sp 95.7%). In terms of reliability, the agreement between US and MRI was almost perfect (κ = .9, P < .001). Conclusion:US may have a role as the initial imaging modality in RA patients with shoulder pain, as it is highly sensitive and specific in detecting different pathological abnormalities of the shoulder. K E Y W O R D S MRI, rheumatoid arthritis, shoulder, ultrasound | 2159 ABDELZAHER Et AL.

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Section: Discussionsupporting

confidence: 92%

Ultrasound versus magnetic resonance imaging in the evaluation of shoulder joint pathologies in a cohort of rheumatoid arthritis patients

et al. 2019

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“…S4 1 ). The Sn and Sp were for each test, respectively: from 0.57 to 0.85 and from 0.49 to 0.72 for the palpation test, (30,47), from 0.47 to 0.83 and from 0.36 to 0.75 for Speed test (47)(48)(49), and from 0.32 to 0.86 and from 0.74 to 0.82 for Yergason's manoeuvre (47)(48)(49). from 0.32 to 0.86 and from 0.78 to 0.88 for Yergason's manoeuvre (37,(47)(48)(49)51) Data from studies assessing Speed test and Yergason's manoeuvre were pooled (Table V, Fig.…”

Section: Hrus Accuracymentioning

confidence: 99%

Accuracy of examination of the long head of the biceps tendon in the clinical setting: A systematic review

Bélanger¹,

Dupuis²,

Leblond³

et al. 2019

J Rehabil Med

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LAY ABSTRACTPeople with shoulder pain seek medical attention in order to relieve their symptoms and improve their quality of life. However, given the complexity of the shoulder girdle, making the right diagnosis can be challenging. Clinicians and other healthcare practitioners base their approach on the findings of current medical history, as well as physical and ultrasound examinations. Once a structure is identified as a potential pain-generator, a specific therapy can be used. The biceps tendon is one such structure. The aim of this study is to assess the accuracy of physical and ultrasound examinations in diag nosing biceps tendon pathologies. This will help to guide clinical decision-making and may prevent delay in seeking specific treatment approaches. Objective: To determine the diagnostic validity of high-resolution ultrasound and orthopaedic special tests in diagnosing long head of the biceps tendon pathologies in patients with shoulder pain. Design: Systematic review with meta-analysis tools. Data sources: MEDLINE, CINAHL and EMBASE. Data extraction: Included studies had to report on the diagnostic validity of orthopaedic special tests or high-resolution ultrasound (HRUS) compared with a reference standard for diagnosing long head of the biceps tendon target conditions (superior labrum anterior and posterior lesions, long head of the biceps tendon tendinopathy, dislocation, effusion or rupture). Risk of bias was assessed using the Quality Assessment Tool for Diagnostic Accuracy Studies (QUADAS-2) tool. Results: Of the 30 included studies, 8 focused on high-resolution ultrasound and 22 on orthopaedic special tests. High-resolution ultrasound proved highly specific for the diagnosis of long head of the biceps tendon pathologies. Pooled positive (LR+) and negative (LR-) likelihood ratios were 38.00 and 0.24 for dislocation, respectively, and 35.50 and 0.30 for complete rupture, respectively. The accuracy of orthopaedic special tests varied greatly across studies. The only test of value was Yergason's ma noeuvre in confirming proximal long head of the biceps tendon pathologies except superior labrum anterior and posterior lesion (high specificity): the summary LR+ and LR-were 2.56 and 0.70, respectively. Conclusion: High-resolution ultrasound is reliable to confirm suspected long head of the biceps tendon pathologies. There is insufficient evidence to recommend individual orthopaedic special tests. JRM Journal of Rehabilitation Medicine 480 V. Bélanger et al. SLAP lesion: histopathology, open surgery, arthroscopy and MR arthrography; LHBT tendinopathy: histopathology and open surgery; LHBT rupture or dislocation: histopathology, open surgery, arthroscopy, MR imaging/arthrography and HRUS.If the reference standard used in the study was not in this list, it was considered an unclear risk of bias. Flow and timingA 1-month period in between the index test and reference standard was considered adequate. We chose this cut-off to minimize disease progression bias, since tendon condition can evolve over time. We ar...

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“…Frequently encountered pathologies in this region are listed in ▶ Table 1. Detailed knowledge of the anatomy of this region and its ultrasound appearance is essential to recognize possible pathologies that correlate with the clinical presentation [1]. The focus of this pictorial essay is to review and discuss the anatomical details of the rotator interval of the shoulder, correlate the anatomy with normal ultrasound images and present selected pathologies.…”

Section: Introductionmentioning

confidence: 99%

The Rotator Interval – A Link Between Anatomy and Ultrasound

Tamborrini¹,

Möller²,

Bong³

et al. 2017

Ultrasound Int Open

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Shoulder pathologies of the rotator cuff of the shoulder are common in clinical practice. The focus of this pictorial essay is to discuss the anatomical details of the rotator interval of the shoulder, correlate the anatomy with normal ultrasound images and present selected pathologies. We focus on the imaging of the rotator interval that is actually the anterosuperior aspect of the glenohumeral joint capsule that is reinforced externally by the coracohumeral ligament, internally by the superior glenohumeral ligament and capsular fibers which blend together and insert medially and laterally to the bicipital groove. In this article we demonstrate the capability of high-resolution musculoskeletal ultrasound to visualize the detailed anatomy of the rotator interval. MSUS has a higher spatial resolution than other imaging techniques and the ability to examine these structures dynamically and to utilize the probe for precise anatomic localization of the patient’s pain by sono-palpation.

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Correlation of findings in clinical and high resolution ultrasonography examinations of the painful shoulder

Cited by 24 publications

References 35 publications

Ultrasound versus magnetic resonance imaging in the evaluation of shoulder joint pathologies in a cohort of rheumatoid arthritis patients

Ultrasound versus magnetic resonance imaging in the evaluation of shoulder joint pathologies in a cohort of rheumatoid arthritis patients

Accuracy of examination of the long head of the biceps tendon in the clinical setting: A systematic review

The Rotator Interval – A Link Between Anatomy and Ultrasound

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