scholarly journals Correlation of clinical examination, ultrasound, magnetic resonance imaging and arthroscopy as diagnostic tools in shoulder pathology

2020 ◽  
Vol 6 (2) ◽  
pp. 247
Author(s):  
Sondipon Biswas ◽  
Naman Kanodia ◽  
Rajat Tak ◽  
Siddharth Agrawal ◽  
Kiran Shankar Roy
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Rotator Cuff ◽  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Gold Standard ◽  
Shoulder Arthroscopy ◽  
Resonance Imaging ◽  
Shoulder Pathologies

<p class="abstract"><strong>Background:</strong> Shoulder pathologies can cause significant pain, discomfort, and affect the activity of daily living. The aim of this study was to compare the efficacy of clinical examination, ultrasound, magnetic resonance imaging (MRI) with shoulder arthroscopy in diagnosing various shoulder pathologies, considering shoulder arthroscopy as the gold standard tool.</p><p class="abstract"><strong>Methods:</strong> This was a prospective, comparative study conducted over 35 patients, between 18-75 years of age presenting with chronic shoulder pain or instability of more than 2 months duration. All patients were examined clinically, followed by high resolution ultrasound, MRI, arthroscopy of the affected shoulder.<strong></strong></p><p class="abstract"><strong>Results:</strong> The sensitivity and specificity of ultrasonography (USG) for diagnosing full thickness tear was 100% each and for MRI was 88% and 100% respectively. For subacromial impingement USG had sensitivity of 66.67%, specificity of 94.12%, positive predictive value of 50% and negative predictive value of 88.89%. For rotator cuff tear USG had sensitivity of 92.86%, specificity of 50%, positive predictive value of 81.25% and negative predictive value of 75% considering shoulder arthroscopy as gold standard.</p><p class="abstract"><strong>Conclusions:</strong> USG and MRI both are sensitive techniques for diagnosing of rotator cuff pathologies. USG has high accuracy in diagnosing partial thickness tears as compare to MRI. MRI proved to be superior in estimation of site and extent of tear. Considering shoulder arthroscopy as gold standard, it can be reserved for patients with suspicious of USG/MRI findings or those who may need surgical intervention simultaneously.</p>

The Crank Test, the O'Brien Test, and Routine Magnetic Resonance Imaging Scans in the Diagnosis of Labral Tears

2002 ◽  
Vol 30 (6) ◽  
pp. 806-809 ◽  
Author(s):  
William B. Stetson ◽  
Kevin Templin
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Shoulder Arthroscopy ◽  
Rotator Cuff Tears ◽  
Resonance Imaging ◽  
Routine Magnetic Resonance Imaging ◽  
Labral Tears

Background Tears of the superior labrum of the shoulder, anterior to posterior, are difficult to diagnose clinically. Purpose We examined whether the crank or O'Brien tests were reliable tools for detecting glenoid labral tears. Study Design Nonrandomized prospective study. Methods Results of diagnostic shoulder arthroscopy were compared with those of the preoperative tests and magnetic resonance imaging for 65 patients who had symptoms of shoulder pain. Results The crank test result was positive in 29 patients (45%), and the O'Brien test was positive in 41 patients (63%). The crank test had a positive predictive value of 41%, was 56% specific, 46% sensitive, and had a negative predictive value of 61%. The O'Brien test had a positive predictive value of 34%, was 31% specific, 54% sensitive, and had a negative predictive value of 50%. Magnetic resonance imaging had a positive predictive value of 63%, was 92% specific, 42% sensitive, and had a negative predictive value of 83%. Conclusions The O'Brien and crank tests were not sensitive clinical indicators for detecting glenoid labral tears and other tears of the anterior and posterior labrum. Results were often falsely positive for patients with other shoulder conditions, including impingement or rotator cuff tears.

scholarly journals Positive Predictive Value of Magnetic Resonance Imaging in Intradural Spinal Tumors Taking Histopathology as Gold Standard

2020 ◽  
Vol 24 (1) ◽  
Author(s):  
HAFEEZ-UR -REHMAN ◽  
ADNAN YOUSAF ◽  
MUHAMMAD USMAN ◽  
MUHAMMAD NOUMAN AKRAM
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Positive Predictive Value ◽  
Predictive Value ◽  
Gold Standard ◽  
Spinal Tumor ◽  
Spinal Tumors ◽  
Radiology Department ◽  
Resonance Imaging ◽  
Female Ratio

Objective: To observe the positive predictive value of MRI, taking histopathology as gold standard in detecting spinal intradural tumors.Materials and Methods: Total 180 cases were included through non-probability purposive sampling, at Ganga Ram Hospital, Radiology department, Lahore. The radiological diagnosis obtained through MRI, was observed. The cases fit in inclusion criteria were underwent surgery and their histopathological findings were observed. Comparison between the outcomes of MRI and histopathology were undertaken, keeping histopathology as gold  standard. Positive predictive value of MRI in the diagnosis of intradural spinal tumor was calculated andpresented in the form of percentages and frequency.Results: There were total 180 patients presenting in OPD with the mean age of 45.71 ± 13.57 years. There were 112 (62%) male. Male to female ratio was 1.6:1. There were 134 (74.4%) cases who were positive for malignant spinal intradural tumor on histopathology showing the PPV of MRI as 74.4%.Conclusion: Magnetic Resonance Imaging is very beneficial imaging tool for early diagnosis of spinal cord tumors.

The Role of Non-Echoplanar Diffusion-Weighted Magnetic Resonance Imaging in Diagnosis of Primary Cholesteatoma and Cholesteatoma Recidivism as an Adjunct to Clinical Evaluation

2018 ◽  
Vol 127 (12) ◽  
pp. 919-925 ◽  
Author(s):  
Roman D. Laske ◽  
Thomas N. Roth ◽  
Krisztina Baráth ◽  
Bernhard Schuknecht ◽  
Alexander M. Huber ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Sensitivity And Specificity ◽  
Predictive Value ◽  
Resonance Imaging ◽  
Diffusion Weighted ◽  
Interrater Variability ◽  
Magnetic Resonance Imaging Mri

Introduction: The aim of this study was to analyze the sensitivity and specificity of non-echoplanar (non-EPI) diffusion-weighted (DW) magnetic resonance imaging (MRI) for the detection of cholesteatoma, with a focus on its value as an adjunct to clinical examination. Methods: In a prospective cohort study, 92 cases were divided into 2 groups: “clinically cholesteatoma” ( n = 79) and “clinically no cholesteatoma” ( n = 13). Non-EPI DW MRI was performed preoperatively in all cases. The presence of a cholesteatoma was assessed by clinicians otoscopically, by neuroradiologists on non-EPI DW MRI, by the surgeon intraoperatively, and finally by the pathologist postoperatively. Data analysis was performed for specificity, sensitivity, positive predictive value, negative predictive value, and interrater variability. Results: The sensitivity and specificity were 89.3% and 75%, respectively, in the “clinically cholesteatoma” group and 0% and 100% in the “clinically no cholesteatoma” group. Non-EPI DW MRI had a positive predictive value of 98.5% when cholesteatoma was suspected clinically and a negative predictive value of 84.6% when cholesteatoma was not suspected clinically. Conclusion: If cholesteatoma is suspected clinically, non-EPI DW MRI is not necessary. If there is no clinical suspicion of cholesteatoma in second-look situations, sensitivity is low and serial follow-up MRI with long intervals is advised.

scholarly journals Correlation between the Findings of Magnetic Resonance Imaging Shoulder and Shoulder Arthroscopy

2020 ◽  
Author(s):  
Zubair Younis Ringshawl ◽  
Ajaz Ahmad Bhat ◽  
Zahid Bashir ◽  
Munir Farooq ◽  
Mubashir Maqbool Wani
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Rotator Cuff ◽  
Shoulder Pain ◽  
Rotator Cuff Tear ◽  
Shoulder Arthroscopy ◽  
Synovial Chondromatosis ◽  
Resonance Imaging ◽  
Cuff Tear ◽  
Shoulder Pathologies

Introduction: Shoulder pain is a significant cause of decreased functional activity of an individual. The overall prevalence of shoulder pain is 16-26%, which makes it the third most common cause among musculoskeletal complaints. The cause of pain in the shoulder is often difficult to evaluate, and diagnosis is usually ambiguous because physical findings are poorly reproducible. The diagnosis therefore, requires multiple imaging modalities. Therapeutic arthroscopy is “the current gold standard” for diagnosing shoulder pathologies, however the procedure is invasive, needs hospitalisation and anaesthesia. Aim: To correlate the findings of Magnetic Resonance Imaging (MRI) shoulder with the findings of shoulder arthroscopy and subsequently determine sensitivity, specificity and accuracy of MRI in diagnosing shoulder pathologies. Materials and Methods: Forty two patients suffering from chronic shoulder pain for a period of more than six weeks, having symptoms of instability, clinical signs of tear or impingement, or functional limitation of the affected shoulder were included in this study. The patients included were in the age group of 18-80 years. Subsequently, MRI followed by arthroscopy of the shoulder was done and the findings of MRI were compared to that of arthroscopy using kappa statistics. Results: In this study along with rotator cuff tear (26 patients), subacromial bursitis (26 patients), was the other most common shoulder pathology. The sensitivity of MRI in detecting shoulder pathologies varied from poor (0.28) for Superior Labrum Anterior Posterior (SLAP) lesion to very good (0.88) for Bankart’s tear and (0.8) for synovial chondromatosis to excellent for rotator cuff tears (0.92). Although sensitivity of MRI was variable for different shoulder pathologies, specificity was comparatively high in detecting all of the above shoulder pathologies. The accuracy of MRI was highest (0.95) in diagnosing synovial chondromatosis, followed by bankart’s lesion (0.92), and rotator cuff tear (0.88). Conclusion: MRI is a very useful and effective tool in diagnosing various shoulder pathologies with exception of SLAP tears where its sensitivity diminishes significantly.

PP141 Functional Connectivity Magnetic Resonance Imaging To Detect Autism

2019 ◽  
Vol 35 (S1) ◽  
pp. 64-65
Author(s):  
Mar Polo-DeSantos ◽  
Juan Pablo ◽  
Chalco Orrego ◽  
Ana Isabel Hijas-Gómez ◽  
Setefilla Luengo-Matos ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Functional Connectivity ◽  
Predictive Value ◽  
Gold Standard ◽  
Neurodevelopmental Disorder ◽  
Negative Likelihood Ratio ◽  
Cochrane Library ◽  
Resonance Imaging ◽  
Functional Connections

IntroductionAutism is a neurodevelopmental disorder characterized by alterations in the intellectual, social, communication, and behavioral capabilities of an individual, and is rarely detected in children before 24 months of age. Early diagnosis and intervention may be more effective at a younger age. Functional connectivity magnetic resonance imaging (fcMRI) of 6-month old infants may be able to identify brain connection patterns related to at least one of the characteristics of autism, which normally appear at 24 months of age, by using a mathematical model to analyze the neuroimaging data.MethodsClinical studies published up to December 2018 that used fcMRI to detect autism in infants were reviewed. The literature databases searched included PubMed, Web of Science, the Trip Database, DynaMed, the Cochrane Library, the International Clinical Trials Registry Platform, and ClinicalTrials.gov. Early assessments of fcMRI analysis were identified through the Early Awareness and Alert System of the Agencia de Evaluación de Tecnologías Sanitarias.ResultsOnly one prospective study of 59 infants at 6-months of age was retrieved. A fcMRI analysis was performed to identify 2,635 pairs of functional connections from 230 brain regions. The infants were subsequently assessed for autism at 24 months of age using gold standard tests. The functional connections correlated with at least one of the behaviors related to autism evaluated at 24 months of age. Eleven infants (19%) were diagnosed with autism at 24 months. Compared with the gold standard test results, the predictive model achieved the following: sensitivity 0.82 (95% confidence interval [CI]: 0.52 - 0.95); specificity 1.00 (95% CI: 0.93–1.00); positive predictive value 1.00 (95% CI: 0.70–1.00); negative predictive value 0.96 (95% CI: 0.87–0.99); and negative likelihood ratio 0.18 (95% CI: 0.05–0.64). Adverse effects were not reported in the study.ConclusionsThe fcMRI analysis could help in early detection of autism and the development of preventive interventions. However, the evidence is sparse and more well-designed studies are needed.

The Diagnostic Accuracy of Magnetic Resonance Imaging and Ultrasonography in Gluteal Tendon Tears -A Systematic Review

2011 ◽  
Vol 21 (6) ◽  
pp. 637-645 ◽  
Author(s):  
Daniel J. Westacott ◽  
Jonathon I. Minns ◽  
Pedro Foguet
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Positive Predictive Value ◽  
Predictive Value ◽  
Imaging Modality ◽  
High Signal ◽  
Diagnostic Strategy ◽  
Resonance Imaging ◽  
Trochanteric Bursitis ◽  
Tendon Tears

Gluteal tendon tears are one of the many pathologies causing pain around the greater trochanter that are often labelled as trochanteric bursitis. We systematically reviewed the peer-reviewed literature to establish the accuracy of magnetic resonance imaging and ultrasonography in the diagnosis of gluteal tendon tears in patients with persistent lateral hip pain or Greater Trochanteric Pain Syndrome (GTPS). 7 studies met the inclusion criteria, comparing either imaging modality with a reference standard of surgical findings. Included studies were assessed for methodological quality using the QUADAS checklist. MRI had sensitivity of 33–100%, specificity of 92–100%, positive predictive value of 71–100% and negative predictive value of 50%. False-positives were common. High signal located superior to the trochanter had a stronger association with tears. Ultrasonography had a sensitivity of 79–100% and positive predictive value of 95–100%. The amount and quality of literature on the subject is limited and further well-designed studies are required to establish the optimum diagnostic strategy in this condition. Ultrasonography may prove to be the investigation of choice, despite requiring a skilled practitioner. The orthopaedic surgeon should liaise with an experienced musculoskeletal radiologist to best investigate and diagnose gluteal tendon tears in the clinical picture of GTPS.

scholarly journals Echocardiography as a Screening Test for Myocardial Scarring in Children with Hypertrophic Cardiomyopathy

2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Gregory Compton ◽  
Lynne Nield ◽  
Andreea Dragulescu ◽  
Lee Benson ◽  
Lars Grosse-Wortmann
Keyword(s):  
Magnetic Resonance Imaging ◽  
Cardiac Magnetic Resonance ◽  
Hypertrophic Cardiomyopathy ◽  
Magnetic Resonance ◽  
Positive Predictive Value ◽  
Predictive Value ◽  
Screening Test ◽  
Resonance Imaging ◽  
Myocardial Scarring ◽  
Echocardiographic Evidence

Introduction. Hypertrophic cardiomyopathy (HCM) is burdened with morbidity and mortality including tachyarrhythmias and sudden cardiac death. These complications are attributed in part to the formation of proarrhythmic scars in the myocardium. The presence of extensive LGE is a risk factor for adverse outcomes in HCM. Late gadolinium enhancement (LGE) cardiac magnetic resonance imaging (cMRI) is the standard for the noninvasive evaluation of myocardial scars. However, echocardiography represents an attractive screening tool for myocardial scarring. The aim of this study was to compare the suitability of echocardiography to detect myocardial scars to the standard of cMRI-LGE.Methods. The cMRI studies and echocardiograms from 56 consecutive children with HCM were independently evaluated for the presence of cMRI-LGE and echocardiographic evidence of scarring by expert readers.Results. Echocardiography had a high sensitivity (93%) and negative predictive value (94%) in comparison to LGE. The false positive rate was high, leading to a low specificity (37%) and a low positive predictive value (35%).Conclusions. Given the poor specificity and positive predictive value, echocardiography is not a suitable screening test for the presence of myocardial scarring in children with HCM. However, children without echocardiographic evidence of myocardial scarring may not need to undergo cardiac magnetic resonance imaging to “rule in” LGE.

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