Diagnostic Value of Stress Radiography in Lesions of the Lateral Ligaments of the Ankle

1988 ◽  
Vol 29 (6) ◽  
pp. 711-714 ◽  
Author(s):  
J. Ahovuo ◽  
E. Kaartinen ◽  
P. Slätis
Keyword(s):  
Diagnostic Accuracy ◽  
Ankle Joint ◽  
Predictive Value ◽  
Diagnostic Value ◽  
Positive Test ◽  
Lateral Ligament ◽  
Stress Radiography ◽  
Anterior Displacement ◽  
Lateral Ligaments ◽  
Talar Tilt

The diagnostic accuracy of inversion and anterior stress radiography in rupture of the lateral ligaments of the ankle joint was assessed in 56 patients undergoing surgery. In inversion stress radiography, 58 per cent of the patients with confirmed rupture of the lateral ligaments of the ankle had a talar tilt of 10 degrees or more, allowing a predictive value of a positive test of 94 per cent. In anterior stress radiography, 53 per cent of the patients had a posterior tibiotalar distance of 9 mm or more, allowing a predictive value of a positive test of 81 per cent. In measurements of talar tilt and anterior displacement of the talus values higher than normal in the injured ankle may be a sign of a rupture of the lateral ligament.

scholarly journals The Diagnostic Value of the Clarke Sign in Assessing Chondromalacia Patella

2008 ◽  
Vol 43 (2) ◽  
pp. 190-196 ◽  
Author(s):  
Scott T. Doberstein ◽  
Richard L. Romeyn ◽  
David M. Reineke
Keyword(s):  
Likelihood Ratio ◽  
Predictive Value ◽  
Arthroscopic Surgery ◽  
Diagnostic Value ◽  
Quadriceps Muscle ◽  
Positive Test ◽  
Visual Evidence ◽  
Chondromalacia Patella ◽  
History Of ◽  
Arthroscopic Examination

Abstract Context: Various techniques have been described for assessing conditions that cause pain at the patellofemoral (PF) joint. The Clarke sign is one such test, but the diagnostic value of this test in assessing chondromalacia patella is unknown. Objective: To (1) investigate the diagnostic value of the Clarke sign in assessing the presence of chondromalacia patella using arthroscopic examination of the PF joint as the “gold standard,” and (2) provide a historical perspective of the Clarke sign as a clinical diagnostic test. Design: Validation study. Setting: All patients of one of the investigators who had knee pain or injuries unrelated to the patellofemoral joint and were scheduled for arthroscopic surgery were recruited for this study. Patients or Other Participants: A total of 106 otherwise healthy individuals with no history of patellofemoral pain or dysfunction volunteered. Main Outcome Measure(s): The Clarke sign was performed on the surgical knee by a single investigator in the clinic before surgery. A positive test was indicated by the presence of pain sufficient to prevent the patient from maintaining a quadriceps muscle contraction against manual resistance for longer than 2 seconds. The preoperative result was compared with visual evidence of chondromalacia patella during arthroscopy. Results: Sensitivity was 0.39, specificity was 0.67, likelihood ratio for a positive test was 1.18, likelihood ratio for a negative test was 0.91, positive predictive value was 0.25, and negative predictive value was 0.80. Conclusions: Diagnostic validity values for the use of the Clarke sign in assessing chondromalacia patella were unsatisfactory, supporting suggestions that it has poor diagnostic value as a clinical examination technique. Additionally, an extensive search of the available literature for the Clarke sign reveals multiple problems with the test, causing significant confusion for clinicians. Therefore, the use of the Clarke sign as a routine part of a knee examination is not beneficial, and its use should be discontinued.

scholarly journals Diagnostic value of virtual autopsy using pm-MRI at 3T on malformed second trimester fetuses vs classic autopsy

PLoS ONE ◽  
2021 ◽  
Vol 16 (11) ◽  
pp. e0260357
Author(s):  
Adelina Staicu ◽  
Camelia Albu ◽  
Roxana Popa-Stanila ◽  
Cosmina Ioana Bondor ◽  
Ioana Cristina Rotar ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Predictive Value ◽  
Diagnostic Value ◽  
Kappa Coefficient ◽  
Termination Of Pregnancy ◽  
Diagnostic Utility ◽  
Second Trimester ◽  
Virtual Autopsy ◽  
Group A ◽  
Cardiac Group

Objective To determine the diagnostic value of virtual autopsy using post mortem-MRI (pm-MRI) at 3Tesla (T) compared to classic autopsy for the confirmation of fetal structural anomalies and secondly to establish which cases of termination of pregnancy would benefit mostly from a virtual autopsy. Methods In each of 32 fetuses included in the study, 32 anatomical structures were assessed, after termination of pregnancy in the second trimester. All cases were evaluated by prenatal ultrasonography, virtual autopsy and classic autopsy, and then divided into four groups: Cerebral Group, Cardiac Group, Renal Group and Other Group (miscellaneous group). The concordance of virtual autopsy with classic autopsy was calculated overall and for each group and each structural item. Also, the concordance between the two methods was assessed using a diagnostic error score (DgE_score), calculated as the absolute value of the difference between the number of malformations detected by classic autopsy per case (CA score) and the number of malformations detected at virtual autopsy per case (VA score). Results Overall virtual autopsy demonstrated a diagnostic sensitivity (Se) compared to classic autopsy of 67.33% [95% CI 57.28–76.33], with a specificity (Sp) of 98.37% [95% CI 97.33–99.09], a positive predictive value (PPV) of 81.93% [95% CI 71.95–89.52], a negative predictive value (NPV) of 96.49% [95% CI 95.11–97.57] achieving a diagnostic accuracy of 95.31% [95% CI 93.83–96.52]. Overall, no statistic significant correlation was demonstrated between DgE_score and the gestational age of the fetuses or between DgE_score and the weight of the fetuses, but a significant correlation was revealed between the virtual autopsy and classic autopsy score. The diagnostic utility of virtual autopsy using pm-MRI at 3 T as compared to classic autopsy for each category of termination of pregnancy revealed in the Cerebral Group a Se of 80.00% [95% CI 28.36–99.49], with a 96.30% [95% CI 81.03–99.91], a PPV of 80.00% [95% CI 35.75–96.64] a NPV of 96.30% [95% CI 81.81–99.34], with a diagnostic accuracy of 93.75% [95% CI 79.19% to 99.23] and a Cohen’s Kappa coefficient of 0.76 [95% CI 0.4494–1.0765]; in the Renal Group a Se and Sp of 100%, but in the Cardiac Group the Se was only 60.00% [95% CI 26.24–87.84], Sp 75% [95% CI 34.91–96.81], the PPV 75.00% [95% CI 44.92–91.69], NPV 60% [95% CI 38.87–77.96], with a diagnostic accuracy of 66.67% [95% CI 40.99–86.66] and a Cohen’s Kappa coefficient of 0.32 [95% CI -0.07–0.76]. Conclusions The results support virtual autopsy using pm-MRI at 3T as a reliable alternative to classic autopsy for the non-forensic analysis of second trimester fetuses. Analyzing the diagnostic utility of virtual autopsy using pm-MRI at 3 T for the confirmation of prenatal ultrasound findings in second trimester fetuses as compared to classic autopsy, the best results were obtained in the Cerebral and Renal Group. Reserved results were found in the Cardiac Group. Therefore, for the pregnancies with termination of pregnancy for cerebral or renal abnormalities, virtual autopsy by pm-MRI at 3T can be taken into consideration as a first-line investigation to confirm the prenatal findings.

Diagnostic value of measuring pancreatic lipase and the P3 isoform of the pancreatic amylase isoenzyme in serum of hospitalized hyperamylasemic patients.

1989 ◽  
Vol 35 (3) ◽  
pp. 417-421 ◽  
Author(s):  
M Panteghini ◽  
F Pagani
Keyword(s):  
Acute Pancreatitis ◽  
Pancreatic Lipase ◽  
Predictive Value ◽  
Diagnostic Value ◽  
Positive Test ◽  
Diagnostic Efficiency ◽  
Isoenzyme Analysis ◽  
Cellulose Acetate Electrophoresis ◽  
Negative Results ◽  
False Positive Test

Abstract We assayed amylase (AMY) isoenzymes by cellulose acetate electrophoresis and determined pancreatic lipase (LPS) activity by a turbidimetric colipase-supplemented method in 54 hospitalized hyperamylasemic patients (32 men and 22 women; mean age 61.5, SD 16, years). In AMY isoenzyme analysis, use of a value for P3 isoform greater than 14 U/L as a positive test for acute pancreatitis gave a diagnostic efficiency of 92.6%, a predictive value of a positive test result of 90.5%, and a predictive value of a negative test of 100%. Four of 12 patients with other, nonpancreatic abdominal diseases had false-positive test results. LPS activity (cutoff limit, 700 U/L) was as effective as P3 isoform in distinguishing patients with acute pancreatitis (sensitivity, 100%) from those without acute pancreatitis (specificity, 81.3%). Thus, P3 isoform and LPS appear to be interchangeable markers of pathological release of pancreatic enzymes into the bloodstream during acute pancreatitis. This finding decreases the need for the expensive radiological procedures currently required to confirm this diagnosis. In particular, negative results virtually exclude acute pancreatitis.

Anatomical Reconstruction of the Lateral Ligaments of the Ankle with a Gracilis Autograft

2005 ◽  
Vol 33 (6) ◽  
pp. 814-823 ◽  
Author(s):  
Masato Takao ◽  
Kazunori Oae ◽  
Yuji Uchio ◽  
Mitsuo Ochi ◽  
Haruyasu Yamamoto
Keyword(s):  
Anatomical Reconstruction ◽  
Anterior Talofibular Ligament ◽  
Stress Radiography ◽  
Lateral Instability ◽  
Calcaneofibular Ligament ◽  
Interference Fit ◽  
Lateral Ligaments ◽  
Anchoring System ◽  
The Mean ◽  
Talar Tilt

Background Few anatomical and minor invasive procedures have been reported for surgical reconstruction of the lateral ligaments to treat lateral instability of the ankle. Furthermore, there are no standards according to which ligaments should be reconstructed. Hypothesis A new technique for anatomically reconstructing the lateral ligaments of the ankle using an interference fit anchoring system and determining which ligaments need to be reconstructed according to the results of standard stress radiography of the talocrural and subtalar joints will be effective for treating lateral instability of the ankle. Study Design Case series; level of evidence, 4. Methods Twenty-one patients with lateral instability of the ankle underwent surgery using the proposed interference fit anchoring system. Standard stress radiographs of the subtalar joint were performed, and if the talocalcaneal angle was less than 10°, only the anterior talofibular ligament was reconstructed; if there was a 10° or greater opening of the talocalcaneal angle, both the anterior talofibular ligament and the calcaneofibular ligament were reconstructed. Results In the 17 patients who received only the anterior talofibular ligament reconstruction, the mean talar tilt angle on standard stress radiography of the talocrural joint was 14.5°± 1.7° before surgery and 2.6°± 0.8° 2 years after surgery (P <. 0001). For the 4 patients who had both the anterior talofibular ligament and calcaneofibular ligament reconstructed, the mean talar tilt angle was 16.5°± 1.5° before surgery and 3.0°± 0.5° 2 years after surgery (P =. 0015). The overall mean talocalcaneal angle on standard stress radiography of the subtalar joint was 11.3°± 1.4° before surgery and 3.5°± 0.8° 2 years after surgery (P =. 0060). Conclusion The proposed system has several advantages, including anatomical reconstruction with normal stability and range of motion restored, the need for only a small incision during the reconstruction, and sufficient strength at the tendon graft-bone tunnel junction, in comparison with the tension strength of the lateral ligaments of the ankle.

The diagnostic accuracy of wrist cineradiography in diagnosing scapholunate dissociation

2013 ◽  
Vol 39 (3) ◽  
pp. 263-271 ◽  
Author(s):  
G. S. I. Sulkers ◽  
N. W. L. Schep ◽  
M. Maas ◽  
C. M. A. M. van der Horst ◽  
J. C. Goslings ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Predictive Value ◽  
Diagnostic Value ◽  
Inclusion Criteria ◽  
Scapholunate Ligament ◽  
Scapholunate Dissociation ◽  
Post Test ◽  
Sensitivity Specificity ◽  
Post Test Probability ◽  
Test Probability

Ruptures of the scapholunate ligament (SLL) may cause carpal instability, also known as scapholunate dissociation (SLD). SLD may lead to osteoarthritis of the radiocarpal and midcarpal joints. The aim of this retrospective study was to determine the diagnostic value of wrist cineradiography in detecting SLD. All cineradiographic studies made during a 24 year period were retrieved. All patients who underwent the confirmation method (arthroscopy and/or arthrotomy) and cineradiography were included. In total, 84 patients met the inclusion criteria. Sensitivity, specificity, likelihood ratio, positive predictive value, negative predictive value, and diagnostic accuracy for detecting SLD were calculated for radiography and cineradiography. Cineradiography had a sensitivity of 90%, a specificity of 97%, and a diagnostic accuracy of 0.93 in detecting SLD. Radiography had a sensitivity of 81%, a specificity of 80%, and a diagnostic accuracy of 0.81. Cineradiography has a high diagnostic value for diagnosing SLDs. A positive cineradiography markedly increases the post-test probability of SLD.

scholarly journals The value of S-Detect in improving the diagnostic performance of radiologists for the differential diagnosis of thyroid nodules

2020 ◽  
Vol 22 (4) ◽  
pp. 415
Author(s):  
Qi Wei ◽  
Shu-E Zeng ◽  
Li-Ping Wang ◽  
Yu-Jing Yan ◽  
Ting Wang ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Predictive Value ◽  
Diagnostic Performance ◽  
Thyroid Nodules ◽  
Characteristic Curve ◽  
Diagnostic Value ◽  
Ultrasound Images ◽  
Experienced Radiologist ◽  
Before And After ◽  
Sensitivity Specificity

Aims: To compare the diagnostic value of S-Detect (a computer aided diagnosis system using deep learning) in differentiating thyroid nodules in radiologists with different experience and to assess if S-Detect can improve the diagnostic performance of radiologists.Materials and methods: Between February 2018 and October 2019, 204 thyroid nodules in 181 patients were included. An experienced radiologist performed ultrasound for thyroid nodules and obtained the result of S-Detect. Four radiologists with different experience on thyroid ultrasound (Radiologist 1, 2, 3, 4 with 1, 4, 9, 20 years, respectively) analyzed the conventional ultrasound images of each thyroid nodule and made a diagnosis of “benign” or “malignant” based on the TI-RADS category. After referring to S-Detect results, they re-evaluated the diagnoses. The diagnostic performance of radiologists was analyzed before and after referring to the results of S-Detect.Results: The accuracy, sensitivity, specificity, positive predictive value and negative predictive value of S-Detect were 77.0, 91.3, 65.2, 68.3 and 90.1%, respectively. In comparison with the less experienced radiologists (radiologist 1 and 2), S-Detect had a higher area under receiver operating characteristic curve (AUC), accuracy and specificity (p <0.05). In comparison with the most experienced radiologist, the diagnostic accuracy and AUC were lower (p<0.05). In the less experienced radiologists, the diagnostic accuracy, specificity and AUC were significantly improved when combined with S-Detect (p<0.05), but not for experienced radiologists (radiologist 3 and 4) (p>0.05).Conclusions: S-Detect may become an additional diagnostic method for the diagnosis of thyroid nodules and improve the diagnostic performance of less experienced radiologists. 

Diagnostic Accuracy of Lightscanning and Mammography in Women with Dense Breasts

1992 ◽  
Vol 33 (1) ◽  
pp. 69-71 ◽  
Author(s):  
O. Jarlman ◽  
I. Andersson ◽  
G. Balldin ◽  
S. A. Larsson
Keyword(s):  
Diagnostic Accuracy ◽  
Invasive Lobular Carcinoma ◽  
Predictive Value ◽  
Lobular Carcinoma ◽  
False Positives ◽  
High Rate ◽  
Positive Test ◽  
Non Invasive ◽  
Dense Breasts

The diagnostic accuracy of lightscanning and mammography in 610 breasts with mammographically dense parenchymal patterns was investigated. Lightscanning identified 31 out of 36 cancers and mammography 32. Lightscanning and mammography were in agreement in 28 cases of cancer. One non-invasive lobular carcinoma was not identified by either modality. Four cancers were not correctly identified with lightscanning alone and 3 cancers with mammography alone. Of the 574 breasts without cancer, lightscanning falsely denoted 101 (18%) as possibly being cancerous (false-positives). The corresponding figure for mammography was 25 (4%). Thus, lightscanning, as performed in this study, has the same sensitivity as mammography in detecting cancer in mammographically dense breasts. However, its usefulness is limited by a low predictive value of a positive test (high rate of false-positives).

scholarly journals Diagnostic Accuracy of Magnetic Resonance Images and Weight-Bearing Radiographs in Patients With Arthroscopic-Proven Medial Osteoarthritis of the Knee

2020 ◽  
Vol 13 ◽  
pp. 117954412093836
Author(s):  
Nuria Muñoz-García ◽  
José Cordero-Ampuero ◽  
Rosario Madero-Jarabo
Keyword(s):  
Magnetic Resonance ◽  
Diagnostic Accuracy ◽  
Predictive Value ◽  
Weight Bearing ◽  
Diagnostic Value ◽  
Magnetic Resonance Images ◽  
Osteoarthritis Of The Knee ◽  
Predictive Values ◽  
Arthroscopic Findings ◽  
Sensitivity Specificity

Aims: The aim of this study is to analyze the diagnostic value of weight-bearing radiographs, magnetic resonance images (MRI), and the combination of both in osteoarthritic knees when using arthroscopic findings as the “gold standard” to compare with. Methods: A total of 59 patients were studied because of chronic pain in 1 of their knees. Radiographs were classified according to Kellgren-Lawrence scale. Magnetic resonance images were classified according to Vallotton, and arthroscopic findings according to Outerbridge criteria. Results: Sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were, respectively, 75.0%, 60.0%, 56.2%, 77.8%, and 66.1% for weight-bearing radiographs, and 70.8%, 88.6%, 81.0%, 81.6%, and 81.4% for MRI. Logistic regression analysis showed that a weight-bearing radiograph added to MRI offered no additional diagnostic value compared with MRI alone ( P < .001). Conclusions: Magnetic resonance images presented higher specificity, positive and negative predictive values, and accuracy than weight-bearing radiographs for knee osteoarthritis. The combination of radiographs and MRI did not improve the diagnostic accuracy, compared with MRI alone.

scholarly journals FAST and abnormal urinalysis: the effective screening tools in pediatric abdominal trauma

2018 ◽  
Vol 5 (1) ◽  
pp. 14-18
Author(s):  
Majid Zamani ◽  
Farhad Heydari ◽  
Mehrdad Esmailian
Keyword(s):  
Diagnostic Accuracy ◽  
Ct Scan ◽  
Abdominal Trauma ◽  
Predictive Value ◽  
Radiation Risk ◽  
Diagnostic Value ◽  
Screening Tools ◽  
Accuracy Evaluation ◽  
Abdominal Ultrasonography ◽  
Predictive Values

Objective: The present study examines the diagnostic accuracy of abdominal ultrasonography and urinalysis test in children with blunt abdominal trauma, compared with CT scan. The aim of this study was to compare the diagnostic value of ultrasound and urinalysis test with CT scan as a golden standard diagnostic method in predicting abdominal peritoneal injury in these patients. Methods: This prospective study, based on diagnostic accuracy evaluation, was performed on children with blunt abdominal traumas less than 12 years of age who were referred to the emergency department from 2017-2018 and for whom abdominal ultrasonography, urinalysis and abdominal CT scans were requested. Demographic data, mechanism of trauma, the results of urine tests, ultrasound and CT scan of the abdomen were recorded. Sensitivity, specificity, positive and negative predictive values were used to measure the diagnostic power of the tests. Results: In this study, 100 children with multiple traumas were included. The mean age of these patients was 5.75 ± 3 years with a range of 1-12 years. In terms of sexual distribution, 69 (69%) were boys and 31 (31%) were girls. According to the results, ultrasound with an abnormal urinalysis test had sensitivity of 85.7%, specificity of 91.9%, positive predictive value of 63.2% and negative predictive value of 97.5%. The accuracy was 91%. Conclusion: According to the results of this study, the combination of ultrasonography and urinalysis resulted in a significant increase in diagnostic value (P <0.001). Pediatric patients with a negative ultrasonography and urinalysis test should be observed rather than subjected to the radiation risk of CT

scholarly journals Diagnostic accuracy of spleen stiffness to evaluate portal hypertension and esophageal varices in chronic liver disease: a systematic review and meta-analysis

2020 ◽  
Author(s):  
Xing Hu ◽  
Xiaojie Huang ◽  
Jianhua Hou ◽  
Lei Ding ◽  
Chunling Su ◽  
...  
Keyword(s):  
Portal Hypertension ◽  
Diagnostic Accuracy ◽  
Esophageal Varices ◽  
Predictive Value ◽  
Meta Analysis ◽  
High Sensitivity ◽  
Diagnostic Value ◽  
Chronic Liver ◽  
Spleen Stiffness ◽  
Sensitivity Specificity

Abstract Objectives To systematically review studies on the diagnostic accuracy of spleen stiffness measurement (SSM) for the detection of clinical significant portal hypertension (CSPH), severe portal hypertension (SPH), esophageal varices (EV), and high-risk esophageal varices (HREV) in patients with chronic liver diseases (CLD). Methods Through a systematic search, we identified 32 studies reporting the accuracy of SSM for the diagnosis of portal hypertension (PH) and/or EV in adults with CLD. A bivariate random-effects model was performed to estimate pooled sensitivity, specificity, likelihood ratio, positive predictive value (PPV), negative predictive value (NPV), and diagnostic odds ratios (DOR). The clinical utility of SSM was evaluated by Fagan plot. Results A total of 32 studies assessing 3952 patients were included in this meta-analysis. The pooled sensitivities of SSM were 0.85 (95% confidence interval (CI), 0.69–0.93) for CSPH; 0.84 (95% CI, 0.75–0.90) for SPH; 0.90 (95% CI, 0.83–0.94) for any EV; and 0.87 (95% CI, 0.77–0.93) for HREV. The pooled specificities of SSM were 0.86 (95% CI, 0.74–0.93) for CSPH; 0.84 (95% CI, 0.72–0.91) for SPH; 0.73 (95% CI, 0.66–0.79) for EV; and 0.66 (95% CI, 0.53–0.77) for HREV. Summary PPV and NPV of SSM for detecting HREV were 0.54 (95% CI, 0.47–0.62) and 0.88 (95% CI, 0.81–0.95), respectively. Conclusions Our meta-analysis suggests that SSM could be used as a helpful surveillance tool in management of CLD patients and was quite useful for ruling out the presence of HREV thereby avoiding unnecessary endoscopy. Key Points • SSM could be used to rule out the presence of HREV in patients with CLD thereby avoiding unnecessary endoscopy. • SSM has significant diagnostic value for CSPH and SPH with high sensitivity and specificity in patients with CLD. • SSM could be used as a helpful surveillance tool for clinicians managing CLD patients.

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