The role of ultrasonography in the diagnosis of talocalcaneal coalitions

2020 ◽  
pp. 028418512094491
Author(s):  
Tiezheng Wang ◽  
Hengtao Qi ◽  
Kai Rong ◽  
Shuqian Zhang ◽  
Shougang Bao ◽  
...  
Keyword(s):  
False Negative ◽  
Fibrous Tissue ◽  
Joint Space ◽  
Clinical Suspicion ◽  
Youden Index ◽  
Imaging Method ◽  
Predictive Values ◽  
Negative Results ◽  
Reduced Space ◽  
Sensitivity Specificity

Background Patients with talocalcaneal coalitions (TCC) often undergo computed tomography (CT). However, ultrasonography diagnosis of TCC has been seldom done according to the literature. Purpose To investigate the accuracy of ultrasonography in diagnosing TCC compared to CT. Material and Methods Ninety-seven consecutive patients with a clinical suspicion of TCC were included. Ultrasonography was used to assess the classification and complication of TCC. The main sonographic criteria for a positive diagnosis in cases of osseous coalition were the joint space between the medial surface of talar head and the underlying sustentaculum tali of calcaneus disappearing and being replaced by a continuous hyperechoic bony structure. In cases of fibrous coalition, ultrasonography revealed a reduced space of the joint associated with an irregular, angular appearance of its outline and hypoechoic fibrous tissue inside. These data were compared with CT findings. κ statistic was applied to determine the level of agreement. The sensitivity, specificity, positive and negative predictive values, accuracy, and Youden index of ultrasonography as a diagnostic method were assessed. Results Ultrasonography findings were positive in 20 of 97 patients with a clinical suspicion of TCC. The diagnosis was confirmed by CT in 21 patients. There were one false-positive result and two false-negative results by ultrasonography. The κ value was 0.907. The sensitivity, specificity, positive and negative predictive values, accuracy, and Youden index of ultrasonography were 90.5%, 98.7%, 95.0%, 97.4%, 96.9%, and 0.892, respectively. Conclusion Ultrasonography could be a reliable, accurate, and non-radioactive diagnostic imaging method in diagnosis of patients with suspected TCC.

Analysis of False-Negative Diagnoses on Endoscopic Brush Cytology of Biliary and Pancreatic Duct Strictures

2000 ◽  
Vol 124 (3) ◽  
pp. 387-392 ◽  
Author(s):  
Roberto Logrono ◽  
Daniel F. Kurtycz ◽  
Claudia P. Molina ◽  
Vipul A. Trivedi ◽  
Jick Y. Wong ◽  
...  
Keyword(s):  
Pancreatic Duct ◽  
Endoscopic Retrograde Cholangiopancreatography ◽  
Tertiary Care ◽  
False Negative ◽  
Pancreatic Ducts ◽  
Brush Cytology ◽  
Endoscopic Retrograde ◽  
Predictive Values ◽  
Negative Results ◽  
Sensitivity Specificity

Abstract Context.—Endoscopic brush cytology is a valuable technique for the diagnosis of pancreatobiliary malignancy. Despite its widespread use, the sensitivity of this method has been reported as approximately 50%. The specificity is usually higher than 95%. Few reports have systematically analyzed the reasons for this relatively low sensitivity. Objectives.—To determine the rate and reasons for false-negative diagnoses in endoscopic brushing cytology of biliary and pancreatic ducts based on the results of sensitivity, specificity, accuracy, and positive and negative predictive values. Design.—Retrospective analysis of laboratory data and slide review of false-negative cases. Setting.—Two tertiary care state university hospitals. Patients.—A total of 183 pancreatobiliary brushing specimens obtained from patients undergoing endoscopic retrograde cholangiopancreatography for biliary or pancreatic duct disease for a 4- to 5-year period. Intervention.—Endoscopic retrograde cholangiopancreatography brushings. Main Outcome Measures.—Determination of sensitivity, specificity, accuracy, and positive and negative predictive values. Analysis of false-negative results. Results.—The sensitivity, specificity, accuracy, and positive and negative predictive values, overall, were 48%, 98%, 79%, 92%, and 76%, respectively. Sampling error was a major cause of false-negative diagnoses (67%), followed by interpretive (17%) and technical errors (17%). Conclusions.—Improvements in sensitivity and diagnostic accuracy for cancer of the pancreatobiliary tract can be achieved by optimizing slide preparatory techniques. Also, enhancement of the cytologist's diagnostic skills enables the identification of the morphologic features of premalignant lesions. Repeat brushings are indicated for suspicious or negative results not consistent with the clinical or radiologic findings.

scholarly journals Characterization of Focal Liver Lesions using CEUS and MRI with Liver-Specific Contrast Media: Experience of a Single Radiologic Center

2017 ◽  
Vol 38 (06) ◽  
pp. 619-625 ◽  
Author(s):  
Lukas Beyer ◽  
Florian Wassermann ◽  
Benedikt Pregler ◽  
Katharina Michalik ◽  
Janine Rennert ◽  
...  
Keyword(s):  
Contrast Media ◽  
Predictive Value ◽  
False Negative ◽  
Focal Liver Lesions ◽  
Liver Lesions ◽  
Predictive Values ◽  
Negative Results ◽  
False Negative Results ◽  
Sensitivity Specificity

Abstract Aim The purpose of this study was to compare contrast-enhanced ultrasound (CEUS), magnetic resonance imaging (MRI) using liver-specific contrast agent and a combination of both for the characterization of focal liver lesions (FLL). Methods 83 patients with both benign and malignant liver lesions were examined using CEUS and MRI after the intravenous administration of liver-specific contrast media. All patients had inconclusive results from prior imaging examinations. Histopathological specimens could be obtained in 53 patients. Ultrasound was performed using a multi-frequency curved probe (1 – 6 MHz) after the injection of 1 – 2.4 ml ultrasound contrast media. The sensitivity, specificity, positive predictive value and negative predictive value of CEUS, MRI and a combination of both (CEUS + MRI) were compared. Results The sensitivity, specificity, positive and negative predictive values regarding lesion classification were 90.9 %, 70.6 %, 92.3 % and 66.6 %, respectively, for CEUS; 90.9 %, 82.4 %, 95.2 % and 70.0 %, respectively, for MRI; and 96.9 %, 70.6 %, 92.7 % and 85.7 % respectively, for CEUS + MRI. There were no statistically significant differences. 6 malignant lesions were missed using CEUS or MRI alone (false negatives). The use of both modalities combined reduced the false-negative results to 2. Conclusion CEUS and MRI with liver-specific contrast media are very reliable and of equal informative value in the characterization of focal liver lesions. The number of false-negative results can be decreased using a combination of the two methods.

scholarly journals Performance of anti-SARS-CoV-2 antibody testing in asymptomatic or mild COVID-19 patients: A retrospective study in outbreak on a cruise ship

PLoS ONE ◽  
2021 ◽  
Vol 16 (9) ◽  
pp. e0257452
Author(s):  
Norihito Kaku ◽  
Fumitaka Nishimura ◽  
Yui Shigeishi ◽  
Rina Tachiki ◽  
Hironori Sakai ◽  
...  
Keyword(s):  
False Negative ◽  
Enzyme Linked Immunosorbent Assay ◽  
Cruise Ship ◽  
Igg Antibodies ◽  
Antibody Testing ◽  
Predictive Values ◽  
Blood Samples ◽  
Negative Results ◽  
Sensitivity Specificity

Objectives A few studies on antibody testing have focused on asymptomatic or mild coronavirus disease 2019 (COVID-19) patients with low initial anti-severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antibody responses. Anti-SARS-CoV-2 antibody-testing performance was evaluated using blood samples from asymptomatic or mild COVID-19 patients. Methods Blood samples were collected from 143 COVID-19 patients during an outbreak on a cruise ship 3 weeks after diagnosis. Simultaneously, a follow-up SARS-CoV-2 genetic test was performed. Samples stored before the COVID-19 pandemic were also used to evaluate the lateral flow immunochromatographic assay (LFA) and electrochemiluminescence immunoassay (ECLIA). Titers of anti-SARS-CoV-2 IgM and IgG antibodies against the nucleocapsid and spike proteins were measured using the enzyme-linked immunosorbent assay to confirm which antibodies were influenced on LFA- and ECLIA- false-negative result in crew-member samples. Results Sensitivity, specificity, positive-predictive, and negative-predictive values of LFA-detected IgM antibodies were 0.231, 1.000, 1.000, and 0.613, respectively; those of LFA-detected IgG antibodies were 0.483, 0.989, 0.972, and 0.601, respectively; and those of ECLIA-detected total antibodies were 0.783, 1.000, 1.000, and 0.848, respectively. All antibody titers measured using ELISA were significantly lower in blood samples with negative results than in those with positive results in both LFA and ECLIA. In the patients with negative results from the follow-up genetic testing, IgM-, IgG-, and total-antibody positivity rates were 22.9%, 47.6%, and 72.4%, respectively. Conclusions These findings suggest that anti-SARS-CoV-2 antibody testing has lower performance in asymptomatic or mild COVID-19 patients than required in the guidelines.

The Active Compression Test: A New and Effective Test for Diagnosing Labral Tears and Acromioclavicular Joint Abnormality

1998 ◽  
Vol 26 (5) ◽  
pp. 610-613 ◽  
Author(s):  
Stephen J. O'Brien ◽  
Michael J. Pagnani ◽  
Stephen Fealy ◽  
Scott R. McGlynn ◽  
Joseph B. Wilson
Keyword(s):  
Acromioclavicular Joint ◽  
Sagittal Plane ◽  
False Negative ◽  
The Body ◽  
Full Extension ◽  
Predictive Values ◽  
Negative Results ◽  
Labral Tears ◽  
Second Pain ◽  
Sensitivity Specificity

Labral tears and acromioclavicular joint abnormalities were differentiated on physical examination using a new diagnostic test. The standing patient forward flexed the arm to 90° with the elbow in full extension and then adducted the arm 10° to 15° medial to the sagittal plane of the body and internally rotated it so that the thumb pointed downward. The examiner, standing behind the patient, applied a uniform downward force to the arm. With the arm in the same position, the palm was then fully supinated and the maneuver was repeated. The test was considered positive if pain was elicited during the first maneuver, and was reduced or eliminated with the second. Pain localized to the acromioclavicular joint or “on top” was diagnostic of acromioclavicular joint abnormality, whereas pain or painful clicking described as “inside” the shoulder was considered indicative of labral abnormality. A prospective study was performed on 318 patients to determine the sensitivity, specificity, and positive and negative predictive values of the test. Fifty-three of 56 patients whose preoperative examinations indicated a labral tear had confirmed labral tears that were repaired at surgery. Fifty-five of 62 patients who had pain in the acromioclavicular joint and whose preoperative examinations indicated abnormalilties in the joint had positive clinical, operative, or radiographic evidence of acromioclavicular injury. There were no false-negative results in either group.

The role of serum periostin in the diagnosis of asthma: A meta-analysis

2020 ◽  
Vol 41 (4) ◽  
pp. 240-247
Author(s):  
Lei Yang ◽  
Qingtao Zhao ◽  
Shuyu Wang
Keyword(s):  
Diagnostic Accuracy ◽  
Meta Analysis ◽  
Characteristic Curve ◽  
False Negative ◽  
Summary Receiver Operating Characteristic ◽  
True Negative ◽  
Negative Results ◽  
Noninvasive Biomarker ◽  
Sensitivity Specificity ◽  
Serum Periostin

Background: Serum periostin has been proposed as a noninvasive biomarker for asthma diagnosis and management. However, its accuracy for the diagnosis of asthma in different populations is not completely clear. Methods: This meta-analysis aimed to evaluate the diagnostic accuracy of periostin level in the clinical determination of asthma. Several medical literature data bases were searched for relevant studies through December 1, 2019. The numbers of patients with true-positive, false-positive, false-negative, and true-negative results for the periostin level were extracted from each individual study. We assessed the risk of bias by using Quality Assessment of Diagnostic Accuracy Studies 2. We used the meta-analysis to produce summary estimates of accuracy. Results: In total, nine studies with 1757 subjects met the inclusion criteria. The pooled estimates of sensitivity, specificity, and diagnostic odds ratios for the detection of asthma were 0.58 (95% confidence interval [CI], 0.38‐0.76), 0.86 (95% CI, 0.74‐0.93), and 8.28 (95% CI, 3.67‐18.68), respectively. The area under the summary receiver operating characteristic curve was 0.82 (95% CI, 0.79‐0.85). And significant publication bias was found in this meta‐analysis (p = 0.39). Conclusion: Serum periostin may be used for the diagnosis of asthma, with moderate diagnostic accuracy.

Validity of hearTest Smartphone-Based Audiometry for Hearing Screening in Workers Exposed to Noise

2020 ◽  
Author(s):  
Luma Cordeiro Rodrigues ◽  
Silvia Ferrite ◽  
Ana Paula Corona
Keyword(s):  
Hearing Loss ◽  
High Specificity ◽  
Hearing Screening ◽  
Youden Index ◽  
Hearing Level ◽  
Predictive Values ◽  
Auditory Thresholds ◽  
The Mean ◽  
Low Sensitivity ◽  
Sensitivity Specificity

Abstract Purpose This article investigates the validity of a smartphone-based audiometry for hearing screening to identify hearing loss in workers exposed to noise. Research Design This is a validation study comparing hearing screening with the hearTest to conventional audiometry. The study population included all workers who attended the Brazilian Social Service of Industry to undergo periodic examinations. Sensitivity, specificity, the Youden index, and positive (PPV) and negative predictive values (NPV) for hearing screening obtained by the hearTest were estimated according to three definitions of hearing loss: any threshold greater than 25 dB hearing level (HL), the mean auditory thresholds for 0.5, 1, 2, and 4 kHz greater than 25 dB HL, and the mean thresholds for 3, 4, and 6 kHz greater than 25 dB HL. Note that 95% confidence intervals were calculated for all measurements. Results A total of 232 workers participated in the study. Hearing screening with the hearTest presented good sensitivity (93.8%), specificity (83.9%), and Youden index (77.7%) values, a NPV (97.2%), and a low PPV (69.0%) for the identification of hearing loss defined as any auditory threshold greater than 25 dB HL. For the other definitions of hearing loss, we observed high specificity, PPV and NPV, as well as low sensitivity and Youden index. Conclusion The hearTest is an accurate hearing screening tool to identify hearing loss in workers exposed to noise, including those with noise-induced hearing loss, although it does not replace conventional audiometry.

scholarly journals Value and Diagnostic Efficacy of Fetal Morphology Assessment Using Ultrasound in A Poor-Resource Setting

Diagnostics ◽  
2019 ◽  
Vol 9 (3) ◽  
pp. 109 ◽  
Author(s):  
Ukweh ◽  
Ugbem ◽  
Okeke ◽  
Ekpo
Keyword(s):  
Predictive Value ◽  
Performance Metrics ◽  
Area Under The Curve ◽  
Youden Index ◽  
Likelihood Ratios ◽  
Diagnostic Efficacy ◽  
Predictive Values ◽  
Resource Setting ◽  
Post Test ◽  
Sensitivity Specificity

Background: Ultrasound is operator-dependent, and its value and efficacy in fetal morphology assessment in a low-resource setting is poorly understood. We assessed the value and efficacy of fetal morphology ultrasound assessment in a Nigerian setting. Materials and Methods: We surveyed fetal morphology ultrasound performed across five facilities and followed-up each fetus to ascertain the outcome. Fetuses were surveyed in the second trimester (18th–22nd weeks) using the International Society of Ultrasound in Obstetrics and Gynecology (ISUOG) guideline. Clinical and surgical reports were used as references to assess the diagnostic efficacy of ultrasound in livebirths, and autopsy reports to confirm anomalies in terminated pregnancies, spontaneous abortions, intrauterine fetal deaths, and still births. We calculated sensitivity, specificity, positive and negative predictive values, Area under the curve (AUC), Youden index, likelihood ratios, and post-test probabilities. Results: In total, 6520 fetuses of women aged 15–46 years (mean = 31.7 years) were surveyed. The overall sensitivity, specificity, and AUC were 77.1 (95% CI: 68–84.6), 99.5 (95% CI: 99.3–99.7), and 88.3 (95% CI: 83.7–92.2), respectively. Other performance metrics were: positive predictive value, 72.4 (95% CI: 64.7–79.0), negative predictive value, 99.6 (95% CI: 99.5–99.7), and Youden index (77.1%). Abnormality prevalence was 1.67% (95% CI: 1.37–2.01), and the positive and negative likelihood ratios were 254 (95% CI: 107.7–221.4) and 0.23 (95% CI: 0.16–0.33), respectively. The post-test probability for positive test was 72% (95% CI: 65–79). Conclusion: Fetal morphology assessment is valuable in a poor economics setting, however, the variation in the diagnostic efficacy across facilities and the limitations associated with the detection of circulatory system anomalies need to be addressed.

scholarly journals THE ROLE OF ULTRASONOGRAPHY IN THE DETECTION OF UROLITHIASIS IN PATIENTS WITH ACUTE RENAL COLIC

2020 ◽  
Vol 4 (6) ◽  
Author(s):  
Sanjay Narayangiri Gosavi ◽  
Virendra K Meena ◽  
Ayush Tambi
Keyword(s):  
Ct Scan ◽  
Renal Colic ◽  
False Negative ◽  
Helical Ct ◽  
Urinary Stones ◽  
Predictive Values ◽  
Acute Renal Colic ◽  
Mean Size ◽  
Acute Flank Pain ◽  
Sensitivity Specificity

This study was conducted to assess the diagnostic Ultrasonography compared to unenhanced helical CT scan in detecting urinary stones in patients with acute renal colic. This retrospective study comprised of 156 patients who undergo unenhanced urinary tract CT scan and ultrasonography for thought of urolithiasis. Both techniques were used to resolve the presence or absence, site, size, and number of urinary stones, as well as company of any other intra-abdominal pathology. For statistical analysis, the sensitivity, specificity, predictive values, and diagnostic accuracy of ultrasonography were deliberate considering unenhanced CT scan as a gold normal. Unpaired two-tailed student’s t-test was used for judgment between mean size of true positive, false positive, and false negative stones. There were 68 patients having 115 urinary stones. Ultrasound identified 54 stones, missed 43, and falsely diagnosed 18 stones. The mean size of true positive, false positive, and false negative stones were 4.8 ± 3.3 mm, 6 ± 1.8 mm and 4.18 ± 3 mm, respectively. There were 23 patients with other intra-abdominal pathologies, equally detected by both techniques. Ultrasound helped in identifying the cause of acute flank pain in 62% of cases. The overall sensitivity, specificity, positive and negative predictive values, and correctness of ultrasonography in the diagnosis of renal stone disease were 58%, 91%, 79%, 78%, and 78%, respectively. Our study suggests that, despite its limited value in detecting urinary stones, ultrasonography should be performed as an initial assessment in patients with acute flank pain. Unenhanced helical CT should be reserved for patients in whom ultrasonography is uncertain. Keywords: Ultrasonography, CT scan

Difficulties in diagnosing vertebral osteomyelitis in a child

2021 ◽  
Vol 14 (1) ◽  
pp. e236037
Author(s):  
Jonathan Holzmann ◽  
Sunday Pam ◽  
Geoffrey Clark
Keyword(s):  
False Negative ◽  
Vertebral Osteomyelitis ◽  
Delayed Diagnosis ◽  
Abdominal Ultrasound ◽  
Clinical Suspicion ◽  
Thoracic Vertebrae ◽  
Negative Results ◽  
False Negative Results ◽  
The Face ◽  
Initial Imaging

Vertebral osteomyelitis is a rare diagnosis and often delayed diagnosis in children. This is a case of a child presenting with fever, back pain and raised C reactive protein who was found to have a Staphylococcus aureus (S.aureus) bacteraemia. Initial imaging with CT, MRI of the spine and abdominal ultrasound failed to demonstrate a vertebral osteomyelitis or identify another source of the bacteraemia. Due to the high clinical suspicion of a spinal source of the infection, second-line investigations were arranged. A bone scan identified an area of increase metabolic activity in the 12th thoracic vertebrae (T12) and subsequently a diagnosis was confirmed with a focused MRI of T12. This serves as an opportunity to discuss the diagnostic difficulty presented by paediatric vertebral osteomyelitis and more generally the need for clinicians to pursue their clinical suspicion in the face of false negative results to make an accurate and timely diagnosis.

scholarly journals Urea-Fibrinogen Slide Coagulase Test – A Simple Alternative Method for the Rapid Identification of Staphylococcus aureus

2017 ◽  
Vol 10 (1) ◽  
pp. 5-10
Author(s):  
Binita Koirala Sharma ◽  
S Gokhale ◽  
K Sharma
Keyword(s):  
Staphylococcus Aureus ◽  
Sensitivity And Specificity ◽  
Reference Method ◽  
Cost Effective ◽  
Rapid Identification ◽  
Accurate Identification ◽  
Predictive Values ◽  
Negative Results ◽  
Animal Pathogens ◽  
Sensitivity Specificity

Introduction: The accurate identification of Staphylococcus aureus clinical isolates requires a series of tests. Morphological features and slide coagulase test are two criteria on which S. aureus are identified. Resort to tube coagulase test is sought when results of slide coagulase test are equivocal or doubtful. Both coagulase tests detect the enzymes that convert fibrinogen into fibrin. Human, rabbit or sheep pooled plasma is used as substrate for both tests. Slide coagulase test is simpler and faster as compared to tube coagulase test. The plasma could be carrier of many human and animal pathogens like HIV, HBV, HCV etc. Storage of plasma for longer duration is fraught with chances of contamination. Improperly stored plasma can lead to false positive or negative results. Citrated plasma may be unsuitable for this test if contaminated with citrate utilizing bacteria. Considering the role of S. aureus as a common etiological agent in nosocomial and community infections, there is a need of implementing rapid, easy and cost-effective phenotypic test.Objectives: Considering the disadvantages and risks associated with fresh plasma, this study aims to launch for safer, more reliable substitute with longer shelf life that may provide reliable results for prompt identification of S. aureus by slide coagulase test.Methods: The present work evaluates slide coagulase test (SCT), and urea fibrinogen slide coagulase test (UF-SCT) for S. aureus detection considering Tube coagulase test (TCT) as the reference method. Sensitivity, specificity, positive predictive value and negative predictive values of SCT and UF-SCT were calculated using TCT as gold standard. Results: A total of 150 staphylococcal isolates from different clinical specimens ere selected for the evaluation of coagulase tests. All the specimens were subjected to SCT, UF-SCT and TCT. The UF-SCT showed better sensitivity (95.04%), specificity (100%), PPV (100%), and NPV (82.85%) with reference to TCT. UF-SCT showed similar sensitivity and specificity to SCT. None of the isolates were negative in UF-SCT and positive in SCT. Since UF-SCT does not incorporate plasma directly and at the same time has a very good sensitivity and specificity, it is recommended that UF-SCT could replace SCT for identification of S. aureus.Conclusion: The findings of present study shall encourage laboratories to use the urea-fibrinogen slide coagulase test routinely for the rapid identification of S aureus.Journal of Gandaki Medical College  Vol. 10, No. 1, 2017, Page: 5-10

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