Role of conventional MRI and MR arthrography in evaluating shoulder joint capsulolabral-ligamentous injuries in athletic versus non-athletic population

El-Liethy, Nevien Ezzat; Kamal, Hanan; Elsayed, Rania F.

doi:10.1016/j.ejrnm.2016.05.001

Cited by 9 publications

(16 citation statements)

References 15 publications

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“…Recently, multiple high-quality studies [14, 21–23] 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.…”

Section: Introductionmentioning

confidence: 99%

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

Liu

Cheng

Dong

et al. 2019

BMC Musculoskelet Disord

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BackgroundMultiple published studies quantitatively analysing the diagnostic value of MRI, MR arthrography (MRA) and CT arthrography (CTA) for labral lesions of the shoulder have had inconsistent results. The aim of this meta-analysis was to systematically compare the diagnostic performance of MRI, MRA, CTA and CT.MethodsTwo databases, PubMed and EMBASE, were used to retrieve studies targeting the accuracy of MRI, MRA, CTA and CT in detecting labral lesions of the shoulder. After carefully screening and excluding studies, the studies that met the inclusion criteria were used for a pooled analysis, including calculation of sensitivity and specificity with 95% confidence intervals (CIs) and the area under the hierarchical summary receiver operating characteristic (HSROC) curves.ResultsThe retrieval process identified 2633 studies, out of which two reviewers screened out all but 14 studies, involving a total of 1216 patients who were deemed eligible for inclusion in the meta-analysis. The results assessing the diagnostic performance of MRI vs. MRA for detecting labral lesions showed a pooled sensitivity of 0.77 (95% CI 0.70–0.84) vs. 0.92 (95% CI 0.84–0.96), a specificity of 0.95 (95% CI 0.85–0.98) vs. 0.98 (95% CI 0.91–0.99), and an area under the HSROC curve of 3.78 (95% CI 2.73–4.83) vs. 6.01 (95% CI 4.30–7.73), respectively.ConclusionMRA was suggested for use in patients with chronic shoulder symptoms or a pathologic abnormality. MRI is by far the first choice recommendation for the detection of acute labral lesions. CT should be a necessary supplemental imaging technique when there is highly suspected glenoid bone damage.

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Section: Introductionmentioning

confidence: 99%

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

Liu

Cheng

Dong

et al. 2019

BMC Musculoskelet Disord

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“…Another age-matched historical control group consisting of recreational nonoverhead athletes and nonathletes (average age, 35 years) with pain, trauma, or dislocation demonstrated 56% of patients with labral tears on MRA. 8 Despite imaging for a suspected labral pathology, that cohort showed a lower incidence of labral pathologies compared with our overall cohort of acute AC separation (P ¼ .02). Additionally, the incidence of labral tears in the general population has been shown to be low in asymptomatic patients.…”

Section: Resultsmentioning

confidence: 59%

High Prevalence of Superior Labral Anterior-Posterior Tears Associated With Acute Acromioclavicular Joint Separation of All Injury Grades

Shah

Ferkel

Mithoefer

2020

Orthopaedic Journal of Sports Medicine

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Background: Despite the relatively high number of cases of acromioclavicular joint (AC) separation in the athletic population, optimal clinical outcomes are not achieved in every case. Limited data exist regarding the prevalence of intra-articular glenohumeral pathologies (IAPs) associated with acute AC separation of all injury grades. Purpose: To determine the prevalence of IAPs associated with AC separation, regardless of severity. Study Design: Case series; Level of evidence, 4. Methods: A total of 62 patients (mean age, 37.6 years) with acute AC separation were included in this study; 41 were nonoverhead recreational athletes. All patients underwent magnetic resonance arthrography (MRA) to evaluate for IAPs. Arthroscopic data from patients undergoing surgical treatment were correlated with MRA results. Results: Patients sustained acute AC separation of Rockwood grade 1 (16.1%), grade 2 (46.8%), grade 3 (25.8%), and grade 4 (11.3%). A concomitant IAP was present in 48 of 62 (77.4%) patients and included superior labral anterior-posterior tears (72.6%), anterior labral tears (24.2%), posterior labral tears (4.8%), supraspinatus tears (3.2%), and inferior glenohumeral ligament ruptures (1.6%). There were 18 (29.0%) patients who had a concomitant pathology in >1 intra-articular structure (combined IAPs). Additionally, 71.8% of patients with grade 1 and 2 AC separation had associated IAPs, and 23.1% had combined IAPs. Furthermore, in patients younger than 40 years, 64.0% of those with grade 1 to 3 AC separation demonstrated associated labral pathologies. There was no difference when comparing age or severity of AC separation and the prevalence of concomitant labral tears ( P = .36 and .22, respectively). Conclusion: There was a high prevalence of IAPs among patients undergoing MRA after AC separation. While an IAP has been described in association with high-grade AC separation previously, the high prevalence of IAPs in low-grade separation in our study was unexpected and suggests that a thorough evaluation and clinical follow-up for patients with all grades of AC separation may be beneficial.

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“…For investigation of shoulder labral injuries, knee or shoulder cartilage defects, or postsurgical reinjuries, a conventional MRI is often ordered and is often inconclusive. 8,23 As such, either a repeat MRI with the addition of arthrography or a surgical diagnostic evaluation is necessary to determine the true diagnosis. The realization that no single diagnostic tool is perfect or “always” indicated allows for further imaging should the treating physician deem it necessary.…”

Section: Discussionmentioning

confidence: 99%

Risks and Complications Associated With Intra-articular Arthroscopy of the Knee and Shoulder in an Office Setting

McMillan

Chhabra

Hassebrock

et al. 2019

Orthopaedic Journal of Sports Medicine

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Background: Classically, arthroscopy has been considered one of the diagnostic gold standards for assessing intra-articular knee and shoulder abnormality. Purpose: To assess the risks associated with in-office needle arthroscopy. Study Design: Case series; Level of evidence, 4. Methods: A retrospective case series analysis was performed by evaluating consecutive diagnostic needle arthroscopies performed by 13 physicians at 13 independent institutions. The findings of both major and minor complications were reported by each of the 13 surgeons based on office documentation. The data were analyzed as a lump sum of both knee and shoulder cases and then subdivided and examined separately. The patients’ ages ranged from 14 to 78 years, and no statistical difference was noted between the numbers of men and women. A major complication was defined as infection, chondral toxicity, or the need for alternative treatment at an urgent care or emergency room secondary to the procedure. Minor complications were defined as a vasovagal event, pain that persisted after 24 hours, or the need for crutches or sling postprocedure. Results: Of the 1419 cases, no major complications were reported. The overall rate of vasovagal events was 1.9% for all procedures (1.6% in knees, 3% in shoulders). Persistent pain longer than 24 hours postprocedure was reported in 0.3% of cases. No patient required crutches or a sling. Postarthroscopy magnetic resonance imaging was needed in 1.4% of cases. No device failures were reported. Conclusion: Previous literature has evaluated the efficacy, sensitivity, and specificity of in-office diagnostic arthroscopy, and this study validates needle arthroscopy as safe in the office setting, with minimal risk of major or minor complications.

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Role of conventional MRI and MR arthrography in evaluating shoulder joint capsulolabral-ligamentous injuries in athletic versus non-athletic population

Cited by 9 publications

References 15 publications

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

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

High Prevalence of Superior Labral Anterior-Posterior Tears Associated With Acute Acromioclavicular Joint Separation of All Injury Grades

Risks and Complications Associated With Intra-articular Arthroscopy of the Knee and Shoulder in an Office Setting

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