Rotator cuff disorders: How to write a surgically relevant magnetic resonance imaging report?

Tawfik, Ahmed; El-Morsy, Ahmad; Badran, Mohamed Aboelnour

doi:10.4329/wjr.v6.i6.274

Cited by 11 publications

(5 citation statements)

References 51 publications

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“…Other studies evaluated the interobserver agreement for pathologies associated with RCTs among orthopaedic shoulder surgeons and found poor agreement results for acromion morphology (k = 0.06), which is similar to that we found in the present study [4, 9]. In this study, there were good and excellent intraobserver agreement results for long head of the biceps and AC pathologies among the shoulder surgeons and the MSK radiologists; however, there were moderate agreement results for muscle fatty infiltration.…”

Section: Discussionsupporting

confidence: 90%

“…Similar to other studies, we conducted an instructional scoring questionnaire and provided the evaluators with prior training, allowing a standardized assessment of scans with coronal, sagittal and axial cuts in T1- and T2-weighted sequences [4, 9]. Although we conducted a training and standardization for evaluation of the exams, the interobserver agreement results were fair and poor in most evaluations.…”

Section: Discussionmentioning

confidence: 99%

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Magnetic resonance imaging reproducibility for rotator cuff partial tears in patients up to 60 years

Yazigi

Nicolao

Netto

et al. 2019

BMC Musculoskelet Disord

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Background Magnetic resonance imaging (MRI) is the gold standard in diagnosing rotator cuff pathology; however, there is a lack of studies investigating the reliability agreement for supraspinatus partial-thickness tears among orthopaedic surgeons and musculoskeletal (MSK) radiologists. Methods Sixty digital MRI scans (1.5 Tesla) were reviewed by two orthopaedic shoulder surgeons, two MSK radiologists, two fellowship-trained shoulder surgeons, and two fellowship-trained orthopaedic surgeons at two distinct times. Thirty-two scans of partial-thickness tears and twenty-eight scans of the supraspinatus tendon with no tears were included. Supraspinatus tendonosis and tears, long head of the biceps pathology, acromial morphology, acromioclavicular joint pathology and muscle fatty infiltration were assessed and interpreted according to the Goutallier system. After a four-week interval, the evaluators were asked to review the same scans in a different random order. The statistical analyses for the intra- and interobserver agreement results were calculated using the kappa value and 95% confidence intervals. Results The intraobserver agreement for supraspinatus tears was moderate among the MSK radiologists (k = 0.589; 95% CI, 0.446–0.732) and the orthopaedic shoulder surgeons (k = 0.509; 95% CI, 0.324–0.694) and was fair among the fellowship-trained shoulder surgeons (k = 0.27; 95% CI, 0.048–0.492) and the fellowship-trained orthopaedic surgeons (k = 0.372; 95% CI, 0.152–0.592). The overall intraobserver agreement was good (k = 0.627; 95% CI, 0.576–0.678). The intraobserver agreement was moderate for biceps tendonosis (k = 0.491), acromial morphology (k = 0.526), acromioclavicular joint arthrosis (k = 0.491) and muscle fatty infiltration (k = 0.505). The interobserver agreement results for supraspinatus tears were fair and poor among the evaluators: the MSK radiologists and the orthopaedic shoulder surgeons had the highest agreement (k = 0.245; 95% CI, 0.055–0.435). Conclusions In this sample of digital MRI scans, there was an overall good intraobserver agreement for supraspinatus partial tears; however, there were also poor and fair interobserver agreement results. The evaluators with higher levels of experience (the orthopaedic shoulder surgeons and the MSK radiologists) demonstrated better results than evaluators with lower levels of experience. Electronic supplementary material The online version of this article (10.1186/s12891-019-2760-4) contains supplementary material, which is available to authorized users.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 99%

Magnetic resonance imaging reproducibility for rotator cuff partial tears in patients up to 60 years

Yazigi

Nicolao

Netto

et al. 2019

BMC Musculoskelet Disord

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“…In an adolescent patient presenting with a painful shoulder, it may be difficult to distinguish a normally developing acromion with a secondary ossification center from the early formation of an os acromiale on the basis of age alone. Therefore, MRI and SPECT–CT are receiving more and more attention. Winfeld et al .…”

Section: Methods Of Searchingmentioning

confidence: 99%

Os Acromiale: Reviews and Current Perspectives

You

Frostick

Zhang

et al. 2019

Orthopaedic Surgery

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Os acromiale is a developmental defect which results from the lack of an osseous union between the ossification centers of the acromion, leading to the fibrocartilaginous tissue connection. The prevalence of os acromiale is 1% to 15%, and is quite common in the African American population. Os acromiale in adults is easily diagnosed by symptoms and X‐ray, particularly on the axillary view; however, the differential diagnosis of adolescents may require MRI or SPECT–CT. Generally, nonoperative therapy for symptomatic os acromiale should be started, including physiotherapy, nonsteroidal anti‐inflammatory drugs, and injections. Surgical treatment is indicated after failed conservative treatment. In symptomatic patients with fixable acromiale, the tension band technique should be used to make the anterior aspect of the acromion elevated from the humerus head. In patients with small fragments which are unsuitable for reattachment, excision might be the best therapeutic option and lead to good outcomes. Whether using internal fixation or resection, the arthroscopic technique results in a better outcome and fewer complications, especially in older patients or athletes with overhead movement, because of the high incidence of shoulder impingement or rotator cuff tears which can be treated concurrently.

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“…Additionally, a structured report focusing on the rotator cuff [26] was generated in consensus by the same radiologists, assessing:…”

Section: Image Analysismentioning

confidence: 99%

7-T clinical MRI of the shoulder in patients with suspected lesions of the rotator cuff

et al. 2020

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Background: To evaluate feasibility and diagnostic performance of clinical 7-T magnetic resonance imaging (MRI) of the shoulder.Methods: Eight patients with suspected lesions of the rotator cuff underwent 7-T MRI before arthroscopy. Image quality was scored for artifacts, B 1 + inhomogeneities, and assessability of anatomical structures. A structured radiological report was compared to arthroscopy. In four patients, a visual comparison with pre-existing 1.5-T examinations was performed. Results: Regarding image quality, the majority of the sequences reached values above the middle of each scoring scale. Fat-saturated proton density sequences showed least artifacts and best structure assessability. The most homogenous B 1 + field was reached with gradient-echo sequences. Arthroscopy did not confirm tendinopathy/ partial tear of supraspinatus in 5/8 patients, of subscapularis in 5/6, and of infraspinatus in one patient; only a partial lesion of the subscapularis tendon was missed. Pathologic findings of long bicipital tendon, acromioclavicular joint, glenohumeral cartilage, labrum, and subacromial subdeltoideal bursa were mainly confirmed; exceptions were one lesion of the long bicipital tendon, one subacromial bursitis, and one superior glenoid labrum anterior-to-posterior lesion, missed on 7-T MRI. Evaluating all structures together, sensitivity was 86%, and specificity 74%. A better contrast and higher image resolution was noted in comparison to previous 1.5-T examinations. Conclusions: 7-T MRI of the shoulder with diagnostic image quality is feasible. Overrating of tendon signal alterations was the main limitation. Although the diagnostic performance did not reach the current results of 3-T MRI, our study marks the way to implement clinical 7-T MRI of the shoulder.

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Rotator cuff disorders: How to write a surgically relevant magnetic resonance imaging report?

Cited by 11 publications

References 51 publications

Magnetic resonance imaging reproducibility for rotator cuff partial tears in patients up to 60 years

Magnetic resonance imaging reproducibility for rotator cuff partial tears in patients up to 60 years

Os Acromiale: Reviews and Current Perspectives

7-T clinical MRI of the shoulder in patients with suspected lesions of the rotator cuff

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