scholarly journals Resisted adduction sit-up test (RASUT) as a screening tool for pelvic versus hip pathology

Author(s):  
Gregory J Galano ◽  
Timothy F Tyler ◽  
Trevor Stubbs ◽  
Ali Ashraf ◽  
Michael Roberts ◽  
...  

ABSTRACT Groin pain is a common symptom in hip and pelvic pathology and differentiating between the two remains a challenge. The purpose of this study was to examine whether a test combining resisted adduction with a sit-up (RASUT) differentiates between pelvic and hip pathology. The RASUT was performed on 160 patients with complaints of hip or groin pain who subsequently had their diagnosis confirmed by magnetic resonance imaging (MRI) or surgery. Patients were categorized as having pelvic pathology (athletic pubalgia or other) or hip pathology (intra-articular or other). Athletic pubalgia was defined as any condition involving the disruption of the pubic aponeurotic plate. Sensitivity, specificity, positive predictive accuracy, negative predictive accuracy and diagnostic odds ratios were computed. Seventy-one patients had pelvic pathology (40 athletic pubalgia), 81 had hip pathology and 8 had both. The RASUT was effective in differentiating pelvic from hip pathology; 50 of 77 patients with a positive RASUT had pelvic pathology versus 29 of 83 patients with a negative test (P < 0.001). RASUT was diagnostic for athletic pubalgia (diagnostic odds ratio 6.08, P < 0.001); 35 of 45 patients with athletic pubalgia had a positive RASUT (78% sensitivity) and 73 of 83 patients with a negative RASUT did not have athletic pubalgia (88% negative predictive accuracy). The RASUT can be used to differentiate pelvic from hip pathology and to identify patients without athletic pubalgia. This is a valuable screening tool in the armamentarium of the sports medicine clinician.

2017 ◽  
Vol 9 (5) ◽  
pp. 428-435 ◽  
Author(s):  
Susan C. Lee ◽  
Yoshimi Endo ◽  
Hollis G. Potter

Context: Evaluation of groin pain in athletes may be challenging as pain is typically poorly localized and the pubic symphyseal region comprises closely approximated tendons and muscles. As such, magnetic resonance imaging (MRI) and ultrasound (US) may help determine the etiology of groin pain. Evidence Acquisition: A PubMed search was performed using the following search terms: ultrasound, magnetic resonance imaging, sports hernia, athletic pubalgia, and groin pain. Date restrictions were not placed on the literature search. Study Design: Clinical review. Level of Evidence: Level 4. Results: MRI is sensitive in diagnosing pathology in groin pain. Not only can MRI be used to image rectus abdominis/adductor longus aponeurosis and pubic bone pathology, but it can also evaluate other pathology within the hip and pelvis. MRI is especially helpful when groin pain is poorly localized. Real-time capability makes ultrasound useful in evaluating the pubic symphyseal region, as it can be used for evaluation and treatment. Conclusion: MRI and US are valuable in diagnosing pathology in athletes with groin pain, with the added utility of treatment using US-guided intervention. Strength-of Recommendation Taxonomy: C


2020 ◽  
Author(s):  
Maxime Barat ◽  
Philippe Soyer ◽  
Fatima Al Sharhan ◽  
Benoit Terris ◽  
Ammar Oudjit ◽  
...  

Objectives: To discriminate hepatic metastases from pancreatic neuroendocrine tumors (pNET) and hepatic metastases from midgut neuroendocrine tumors (mNET) with magnetic resonance imaging (MRI). Methods: MRI examinations of 24 patients with hepatic metastases from pNET were quantitatively and qualitatively assessed by two blinded readers and compared to those obtained in 23 patients with hepatic metastases from mNET. Inter-reader agreement was calculated with kappa and intraclass correlation coefficient (ICC). Sensitivity, specificity and accuracy of each variable for the diagnosis of hepatic metastasis from pNET were calculated. Associations between variables and primary tumor (i.e., pNET vs. mNET) were assessed at univariate and multivariate analysis. A nomogram was developed and validated using an external cohort of 20 patients with pNET and 20 patients with mNET. Results: Interobserver agreement was strong to perfect (k=0.893-1) for qualitative criteria and excellent for quantitative variables (ICC: 0.9817-0.9996). At univariate analysis, homogeneity on T1-weighted images was the most discriminating variable for the diagnosis of pNET (OR, 6.417; P=0.013) with greatest sensitivity (88%; 21/24; 95% CI: 68-97%). At multivariate analysis, tumor homogeneity on T1-weighted images (P=0.007; OR, 17.607; 95%CI: 2.179–142.295) and target sign on DW images (P=0.007; OR, 19.869; 95%CI: 2.305–171.276) were independently associated with pNET. Nomogram yielded a corrected AUC of 0.894 (95%CI: 0.796–0.992) for the diagnosis of pNET in the training cohort and 0.805 (95%CI: 0.662–0.948) in the validation cohort. Conclusions: MRI provides qualitative features that can help discriminate between hepatic metastases from pNET and those from mNET.


2020 ◽  
Vol 35 (6) ◽  
pp. 363-379
Author(s):  
Katherine Schiller ◽  
Asim F. Choudhri ◽  
Tamekia Jones ◽  
Christen Holder ◽  
James W. Wheless ◽  
...  

Transcranial magnetic stimulation (TMS) is a newer noninvasive language mapping tool that is safe and well-tolerated by children. We examined the accuracy of TMS-derived language maps in a clinical cohort by comparing it against functional magnetic resonance imaging (MRI)–derived language map. The number of TMS-induced speech disruptions and the volume of activation during functional MRI tasks were localized to Brodmann areas for each modality in 40 patients with epilepsy or brain tumor. We examined the concordance between TMS- and functional MRI–derived language maps by deriving statistical performance metrics for TMS including sensitivity, specificity, accuracy, and diagnostic odds ratio. Brodmann areas 6, 44, and 9 in the frontal lobe and 22 and 40 in the temporal lobe were the most commonly identified language areas by both modalities. Overall accuracy of TMS compared to functional MRI in localizing language cortex was 71%, with a diagnostic odds ratio of 1.27 and higher sensitivity when identifying left hemisphere regions. TMS was more accurate in determining the dominant hemisphere for language with a diagnostic odds ratio of 6. This study is the first to examine the accuracy of the whole brain language map derived by TMS in the largest cohort examined to date. While this comparison against functional MRI confirmed that TMS reliably localizes cortical areas that are not essential for speech function, it demonstrated only slight concordance between TMS- and functional MRI–derived language areas. That the localization of specific language cortices by TMS demonstrated low accuracy reveals a potential need to use concordant tasks between the modalities and other avenues for further optimization of TMS parameters.


2017 ◽  
Vol 21 (04) ◽  
pp. 403-414
Author(s):  
William Palmer ◽  
Miriam Bredella ◽  
Arvin Kheterpal

AbstractMusculotendinous disorders of the abdomen and pelvis are common causes of pain in both athletes and nonathletes. Magnetic resonance imaging (MRI) is the modality of choice in the work-up of these patients. This article focuses on the MRI appearance of normal anatomy and spectrum of musculotendinous disorders in the abdomen and pelvis including muscle strains and tears, avulsions and apophysitis, muscular contusions, athletic groin pain, and gluteal aponeurotic/proximal iliotibial band injuries. Normal biomechanics and injury mechanisms are discussed.


2016 ◽  
Vol 19 (1) ◽  
pp. 36-40 ◽  
Author(s):  
Maria N. Chamurlieva ◽  
T. V Korotaeva ◽  
E. Yu Loginova ◽  
E. A Batkaev

The study was carried out in 103 patients with psoriasis, who had the consultation of dermatologist and rheumatologist. Answers for 6 questions mPEST (Psoriasis Epydemiology Screening Tool) modified questionnaire were estimated, each positive answer corresponded to 1, PEST ≥ 3 was suggested the presence of psoriatic arthritis (PsA), PEST < 3 was considered the absence of PsA. All the patients were examined by rheumatologist, the gold standard was CASPAR (ClASsification criteria for Psoriatic Arthritis) criteria. If necessary the instrumental tests were performed: roentgenography, ultrasound examination, magnetic resonance imaging (MRI) and laboratory tests. At PEST ≥ 3 diagnosis of PsA was suspected in 60 (58.2%) of 103 patients. Diagnosis of PsA was confirmed by CASPAR criteria in 47 (45.6%) patients. mPEST less than 3 was in 43 (41.7%) of 103 patients. Diagnosis of PsA was absent by CASPAR criteria in 29 (67.4%) patients. Newly diagnosed PsA was in 32 (52.4%) of 61 patients. Any rheumatic disease, mainly PsA, can develop with psoriasis. mPEST questionnaire in most cases reveals PsA in early stage, however, its isolated use is insufficient to establish an accurate diagnosis, it requires a clear diagnostic algorithm of the disease, including consultation of rheumatologist, clinical and instrumental examination.


2017 ◽  
Vol 98 (1) ◽  
pp. 34-37
Author(s):  
S S Vatankha ◽  
S A Saryev

Aim. To analyze sensitivity of magnetic resonance imaging (MRI) in the diagnosis of breast cancer when used after mammography and breast ultrasound.Methods. The study included 70 patients with nonpalpable breast lesions who had changes of breast tissue found at previous studies (mammography and breast ultrasound). MRI was performed with the use of Siemens Magnetom Avanto with magnetic field 1.5 Tl.Results. Most frequently nonpalpable lesions were diagnosed in 45 to 60-year old patients (60%), a little rarer - in 39 to 45-year old patients (22.9%), in patients at the age of 61 to 69 - in 10.0% (7 patients). 7.1% patients were over 70. All first detected nonpalpable lesions of breast were biopsied for morphological verification. With the combined use of mammography, sonography, MRI and stereotactic biopsy the diagnosis was made in 100% patients. MRI with contract enhancement showed no relation between sensitivity, specificity and reliability and density of breast tissues.Conclusions. MRI is considered a highly sensitive method of diagnosis and identification of changes found at mammography and breast ultrasound.


Author(s):  
Khunsa Faiz ◽  
Alex Botsford ◽  
Namita Sinha ◽  
Simon Walling ◽  
Jai Jai Shiva Shankar

ABSTRACT:Background:The T2 hypointensity has been suggested to be associated with intracranial metastatic adenocarcinomas (IMA). The purpose of our study was to determine the association of T2 hypointensity with IMA.Methods:All patients with pathologically confirmed metastatic brain tumors who had a magnetic resonance imaging (MRI) at our institution in the last 10 years were retrospectively assessed. Qualitative assessment of the lesions on MRI was done by two separate readers who were blinded to the pathological diagnosis. For qualitative assessment, the T2 hypointensity in the lesion was compared with the contralateral normal appearing white matter. Odds ratio, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated.Results:Of 107 patients with intracranial metastasis, only 73 (40 females; 33 males; mean age 61 years) had MRI available for review. Of these, only 46 (25 females; 21 males; mean age 61 years) had pathologically proven IMA. T2 hypointensity was seen in 20% of IMA. The odds ratio of T2 hypointensity in IMA was 3 compared to nonadenocarcinomas but was not statistically significant (p = 0.16). Intralesional hemorrhage was seen in 20. When controlled for hemorrhage, the odds ratio for T2 hypointensity in IMA was 4.7. The specificity, sensitivity, PPV, and NPV for T2 hypointensity to diagnose IMA were 92%, 19%, 81%, and 40%, respectively.Conclusion:T2 hypointensity was seen only in 20% of IMA with an odds ratio of 4.7. T2 hypointensity showed a high specificity and PPV for diagnosis of IMA.


Author(s):  
Saba Murad ◽  
Ishtiaq Ahmed ◽  
Hania Ali ◽  
Maria Ghani ◽  
Sana Murad

Abstract The objective of this study was to determine the diagnostic accuracy of B-scan in predicting retinoblastoma (Rb) taking Magnetic Resonance Imaging (MRI) as a gold standard. A cross-sectional validation study was conducted in the Radiology Department of Fauji Foundation Hospital from  May 20 to Nov 20, 2017. Children fulfilling the inclusion criteria were selected after informed consent and detailed history was taken for investigation of Rb. B-scan of both eyes was done using 7.5-10 MHz probe, followed by MRI of both eyes in the same patients using 1.5 Tesla MRI machine with the help of qualified MRI technicians. Data analysis was done by SPSS version 16.0. The diagnostic accuracy, sensitivity, specificity, PPV and NPV of B-scan in prediction of Rb as compared to MRI was 90.45%, 82.28%, 90.54% and 90.28% respectively. The study concluded that diagnostic accuracy of B-scan as compared to MRI is substantial in Retinoblastoma. Continuous...


2017 ◽  
Vol 68 (2) ◽  
pp. 116-121 ◽  
Author(s):  
Sharon E. Clarke ◽  
Dipan Mistry ◽  
Talal AlThubaiti ◽  
M. Naeem Khan ◽  
David Morris ◽  
...  

Purpose The purpose of this study was to evaluate the sensitivity, specificity, and positive and negative predictive values of the diffusion-weighted periodically rotated overlapping parallel lines with enhanced reconstruction (PROPELLER) technique in the detection of cholesteatoma at our institution with surgical confirmation in all cases. Methods A retrospective review of 21 consecutive patients who underwent diffusion-weighted PROPELLER magnetic resonance imaging (MRI) on a 1.5T MRI scanner prior to primary or revision/second-look surgery for suspected cholesteatoma from 2009-2012 was performed. Results Diffusion-weighted PROPELLER had a sensitivity of 75%, specificity of 60%, positive predictive value of 86%, and negative predictive value of 43%. In the 15 patients for whom the presence or absence of cholesteatoma was correctly predicted, there were 2 cases where the reported locations of diffusion restriction did not correspond to the location of the cholesteatoma observed at surgery. Conclusion On the basis of our retrospective study, we conclude that diffusion-weighted PROPELLER MRI is not sufficiently accurate to replace second look surgery at our institution.


2008 ◽  
Vol 139 (2_suppl) ◽  
pp. P148-P148
Author(s):  
Zameel Dewji ◽  
Brian W Blakley

Objectives To understand the role of oculomotor testing in the era of advanced imaging with MRI. Methods First, the literature was evaluated systematically to determine the level of evidence that oculomotor testing is sensitive in central nervous system lesions. Next, the sensitivity and specificity of saccade, pursuit, and gaze testing in detection of brain abnormalities were assessed using a database of 561 patients who underwent ENG using magnetic resonance imaging (MRI) as the “gold standard.” Among the abnormal MRI scans, oculomotor testing was abnormal in 1 and normal in 37. Sensitivity, specificity, positive and negative predictive values (PPV and NPV), positive and negative likelihood ratios (PLR and NLR), and the diagnostic odds ratio (OR) with 95% confidence interval (± CI) were calculated. Results For oculomotor testing, our data which concur with the literature indicate: Sensitivity 2.6%, (± 0.005–1.1); Specificity 96%, ± (0.89–0.98); Diagnostic OR 0.71 ± (0.065–5.6); PPV 20% ± (0.043, −0.64); NPV 71% ±(0.62, 0.78). Conclusions Our data suggest that oculomotor testing adds little diagnostic information. The cost and benefit of oculomotor testing are low.


Sign in / Sign up

Export Citation Format

Share Document