ROLE OF MRI IN DIAGNOSIS OF ROTATOR CUFF TEAR ASSUMING ARTHROSCOPY AS GOLD STANDARD

Background- Rotator cuff tears are one of the most common causes of shoulder pain for which patients seek treatment. As in our daily work, the shoulder joint is the most frequently used, there is higher chance of having shoulder joint injury. The aim of the study is to compare the efficacy of MRI in diagnosing shoulder pathologies in comparison to arthroscopy, considering arthroscopy as the gold standard. Methods- 30 Patient with suspected rotator cuff injury patients, between 18-80 years of age was included in the study. MRI of the shoulder joint was done followed by shoulder arthroscopy. The data collected was analysed for the significant correlation between MRI of shoulder and arthroscopic findings by kappa statistics. Results- The accuracy of MRI in diagnosis of rotator cuff partial tears, was 90%, while sensitivity and specificity was 100.00%, 78.57% and positive predictive value was 84.21% and negative predictive value was 100.00% and accuracy of MRI in diagnosis of rotator cuff full tears, was 86.67%, while sensitivity and specificity was 63.64%, 100.00%) and positive predictive value was 100.00% and negative predictive value was 82.61% in our study. Conclusion- Our study demonstrates a high sensitivity and specificity for the MRI diagnosis of both partial and full thickness rotator cuff tears and good correlation with arthroscopic findings. Keywords: Rotator cuff, Shoulder pain, Arthroscopy, MRI.

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

International Journal of Research in Orthopaedics ◽

10.18203/issn.2455-4510.intjresorthop20200473 ◽

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

Background: 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.Methods: 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.Results: 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.Conclusions: 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.

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Relationship between Clinical, MRI, and Arthroscopic Findings: A Guide to Correct Diagnosis of Meniscal Tears

Joints ◽

10.1055/s-0037-1605583 ◽

2017 ◽

Vol 05 (03) ◽

pp. 164-167

Author(s):

P. Antinolfi ◽

R. Cristiani ◽

F. Manfreda ◽

S. Bruè ◽

V. Sarakatsianos ◽

...

Keyword(s):

Positive Predictive Value ◽

Prospective Study ◽

Negative Predictive Value ◽

Clinical Examination ◽

Predictive Value ◽

Gold Standard ◽

Careful Examination ◽

Meniscal Tears ◽

Arthroscopic Findings ◽

Clinical Mri

Purpose The aim of this prospective study was to compare and correlate clinical, MRI, and arthroscopic findings in cases of suspected meniscal tears. Using arthroscopic findings as the gold standard, the sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of clinical investigation and MRI were evaluated to determine if is possible, after a careful examination, to bypass MRI and perform directly arthroscopy in suspected cases. Methods A total of 80 patients with a history of knee trauma, preoperative RX, and MRI underwent arthroscopy over an 8-month period at our department. All patients had a clinical examination performed by an experienced knee surgeon. These examiners evaluated and recorded the results of three tests: medial and lateral joint line tenderness test, McMurray's test, and Apley's test. The injury was classified as a meniscal tear if there were at least two positive tests. Finally, using the arthroscopic findings as the gold standard, sensibility, specificity, accuracy, positive and negative predictive values of clinical examination, and MRI were evaluated and compared. Results Clinical examination performed by an experienced knee surgeon reported better sensitivity (91 vs. 85%), specificity (87 vs. 75%), accuracy (90 vs. 82%), positive predictive value (94 vs. 88%), and negative predictive value (81 vs. 71%) than MRI for medial meniscal tears. These parameters showed minimal differences for lateral meniscal tears. Conclusion Clinical examination performed by an experienced knee surgeon provided equal or better results to diagnose meniscal injuries in comparison to MRI. MRI is not necessary to confirm these lesions and should not be used as the primary diagnostic tool. Level of Evidence Level II, prospective study.

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Diagnostic accuracy in rotator cuff tears: clinical tests vs MRI

International Journal of Research in Orthopaedics ◽

10.18203/issn.2455-4510.intjresorthop20192693 ◽

2019 ◽

Vol 5 (4) ◽

pp. 727 ◽

Cited By ~ 1

Author(s):

Divakar Modipalli ◽

Atmananda S. Hegde ◽

Chethan B. Shetty

Keyword(s):

Rotator Cuff ◽

Negative Predictive Value ◽

Clinical Examination ◽

Predictive Value ◽

Rotator Cuff Tears ◽

Clinical Tests ◽

Predictive Values ◽

Rotator Cuff Injuries ◽

Arthroscopic Findings ◽

Mri Evaluation

Background: Till date there is a lack of consensus regarding validity of clinical tests in identifying the rotator cuff injuries and also the predictive value of noninvasive investigations done to confirm such shoulder pathology.Methods: We included 48 patients with shoulder complaints in our study who underwent blinded clinical examination and MRI of shoulder, whose findings were compared with arthroscopic findings and were statistically analyzed.Results: In the study group mean age was 47 years and 71% were males. When compared with arthroscopy, clinical examination for supraspinatus had better sensitivity (90) but low specificity and negative predictive value (NPV) (37.5). MRI evaluation of supraspinatus had specificity of 85 and NPV of 60. Infraspinatus had almost similar statistical values. MRI was found to have better specificity (89.5) in comparison with clinical examination (52.6) in subscapularis evaluation along with higher positive (67 vs. 30) and negative predictive value (94 vs. 90).Conclusions: Clinical examination is good in identifying lesion or tear of supraspinatus and subscapularis but may also have false positives, where usage of noninvasive MRI will reduce these false positive in comparison with gold standard arthroscopy. Although clinical examination is very useful for diagnosis of rotator cuff injuries, MRI could be used to improve specificity and predictive values in patients who are planned for surgical management of rotator cuff injury.

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The sensitivity and specificity of rapid diagnostic test for malaria parasite in comparison to slide microscopy as gold standard

UIC Research Journal ◽

10.17158/522 ◽

2016 ◽

Vol 19 (2) ◽

Author(s):

John Mark De Real

Keyword(s):

Positive Predictive Value ◽

Negative Predictive Value ◽

Diagnostic Test ◽

Rapid Diagnostic Test ◽

Sensitivity And Specificity ◽

Predictive Value ◽

Gold Standard ◽

Malaria Parasite ◽

High Sensitivity ◽

Significant Difference

The main objective of this study was to test the sensitivity and specificity of rapid diagnostic test for malaria parasite in comparison to slide microscopy as gold standard. Data were acquired from blood mass survey of malaria infection conducted in the community of Paquibato district, Davao City. There were 377 total participants examined through Rapid Diagnostic Test (RDT) and slide microscopy. Of the 377 participants tested, 16 (4.24%) of them were positive to Plasmodium falciparum and 68 (18.04%) were positive to Plasmodium vivax using slide microscopy. Of the 16 participants’ positive for P. faciparum, PfRDT (HRP-2) correctly identified 13 expressing 81.25% (low) sensitivity of the tool. Of the 68 participants’ positive for P. vivax, PvRDT (pLDH) correctly identified 65 expressing 95.59% (high) sensitivity. Both of the RDTs (HRP-2 and pLDH), however, attained 100% specificity. PfRDT (HRP-2) has a positive predictive value of 100% and a negative predictive value of 99.2%, likewise PvRDT (pLDH) has a positive predictive value of 100% and a negative predictive value of 99.04%, all in all, suggesting a high degree of reliability of SD BIOLINE Malaria Antigen P.f/P.v. the data showed no significant difference on the performance level of RDT, albeit less sensitive, compared to slide microscopy.Keywords: Health, malaria, sensitivity, specificity, HRP-2, pLDH, descriptive Davao City, Philippines.<div> </div>

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Accuracy of Rotator Cuff Tears and Tendinosis Diagnoses on Shoulder Ultrasound Performed by a Short-experienced Operator

American Journal of Sonography ◽

10.25259/ajs-22-2018 ◽

2018 ◽

Vol 1 ◽

pp. 9

Author(s):

Harshad Arvind Vanjare ◽

Jyoti Panwar

Keyword(s):

Rotator Cuff ◽

Negative Predictive Value ◽

Rotator Cuff Tear ◽

Predictive Value ◽

Rotator Cuff Tears ◽

Mri Findings ◽

Cuff Tear ◽

Experienced Operator ◽

Magnetic Resonance Imaging Mri ◽

Sensitivity Specificity

Objective The objective of the study was to assess the accuracy of ultrasound examination for the diagnosis of rotator cuff tear and tendinosis performed by a short experienced operator, compared to magnetic resonance imaging (MRI) results. Method A total of 70 subjects suspected to have rotator cuff tear or tendinosis and planned for shoulder MRI were included in the study. Shoulder ultrasound was performed either before or after the MRI scan on the same day. Ultrasound operator had a short experience in performing an ultrasound of the shoulder. Ultrasound findings were correlated to MRI findings. Results Sensitivity, specificity, positive predictive value, negative predictive value, and accuracy for the diagnosis of tendinosis were 58%, 84%, 63%, 80%, and 75%, respectively, and it was 68%, 91%, 73%, 88%, and 85%, respectively, for the diagnosis of rotator cuff tear. Conclusions Sensitivity for diagnosing rotator cuff tear or tendinosis was moderate but had a higher negative predictive value. Thus, the ultrasound operator with a short experience in performing shoulder ultrasound had moderate sensitivity in diagnosing tendinosis or tears; however, could exclude them with confidence.

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Agreement in the diagnosis of dental fluorosis in central incisors performed by a standardized photographic method and clinical examination

Cadernos de Saúde Pública ◽

10.1590/s0102-311x2009000500008 ◽

2009 ◽

Vol 25 (5) ◽

pp. 1017-1024 ◽

Cited By ~ 11

Author(s):

Carolina Castro Martins ◽

Loliza Chalub ◽

Ynara Bosco Lima-Arsati ◽

Isabela Almeida Pordeus ◽

Saul Martins Paiva

Keyword(s):

Positive Predictive Value ◽

Negative Predictive Value ◽

Clinical Examination ◽

Predictive Value ◽

Gold Standard ◽

Dental Fluorosis ◽

Digital Camera ◽

High Specificity ◽

Photographic Method ◽

Pediatric Dentists

The aim of this study was to assess agreement in the diagnosis of dental fluorosis performed by a standardized digital photographic method and a clinical examination (gold standard). 49 children (aged 7-9 years) were clinically evaluated by a trained examiner for the assessment of dental fluorosis. Central incisors were evaluated for the presence or absence of dental fluorosis and were photographed with a digital camera. Photographs were presented to three pediatric dentists, who examined the images. Data were analyzed using Cohen's kappa and validity values. Agreement in the diagnosis performed by the photographic method and clinical examination was good (0.67) and accuracy was 83.7%. The prevalence of dental fluorosis was reported to be higher in the clinical examination (49%) compared with the photographic method (36.7%). The photographic method presented higher specificity (96%) than sensitivity (70.8%), a positive predictive value (PPV) of 94.4% and a negative predictive value (NPV) of 77.4%. The diagnosis of dental fluorosis performed using the photographic method presented high specificity and PPV, which indicates that the method is reproducible and reliable for recording dental fluorosis.

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Estimating sensitivity and specificity from positive predictive value, negative predictive value and prevalence: application to surveillance systems for hospital-acquired infections

Journal of Hospital Infection ◽

10.1016/j.jhin.2008.02.021 ◽

2008 ◽

Vol 69 (2) ◽

pp. 164-168 ◽

Cited By ~ 21

Author(s):

H. Kelly ◽

A. Bull ◽

P. Russo ◽

E.S. McBryde

Keyword(s):

Positive Predictive Value ◽

Negative Predictive Value ◽

Sensitivity And Specificity ◽

Predictive Value ◽

Surveillance Systems ◽

Hospital Acquired Infections ◽

Hospital Acquired

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

The American Journal of Sports Medicine ◽

10.1177/03635465020300060901 ◽

2002 ◽

Vol 30 (6) ◽

pp. 806-809 ◽

Cited By ~ 91

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.

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Sensitivity and Specificity of Histoplasma Antigen Detection by Enzyme Immunoassay

Journal of the American Animal Hospital Association ◽

10.5326/jaaha-ms-6202 ◽

2015 ◽

Vol 51 (5) ◽

pp. 306-310 ◽

Cited By ~ 16

Author(s):

Lauren Cunningham ◽

Audrey Cook ◽

Andrew Hanzlicek ◽

Kenneth Harkin ◽

Joseph Wheat ◽

...

Keyword(s):

Confidence Interval ◽

Positive Predictive Value ◽

Enzyme Immunoassay ◽

Negative Predictive Value ◽

Sensitivity And Specificity ◽

Predictive Value ◽

Kappa Coefficient ◽

Urine Samples ◽

Specificity And Sensitivity ◽

Antigen Assay

The objective of this study was to evaluate the sensitivity and specificity of an antigen enzyme immunoassay (EIA) on urine samples for the diagnosis of histoplasmosis in dogs. This retrospective medical records review included canine cases with urine samples submitted for Histoplasma EIA antigen assay between 2007 and 2011 from three veterinary institutions. Cases for which urine samples were submitted for Histoplasma antigen testing were reviewed and compared to the gold standard of finding Histoplasma organisms or an alternative diagnosis on cytology or histopathology. Sensitivity, specificity, negative predictive value, positive predictive value, and the kappa coefficient and associated confidence interval were calculated for the EIA-based Histoplasma antigen assay. Sixty cases met the inclusion criteria. Seventeen cases were considered true positives based on identification of the organism, and 41 cases were considered true negatives with an alternative definitive diagnosis. Two cases were considered false negatives, and there were no false positives. Sensitivity was 89.47% and the negative predictive value was 95.35%. Specificity and the positive predictive value were both 100%. The kappa coefficient was 0.9207 (95% confidence interval, 0.8131–1). The Histoplasma antigen EIA test demonstrated high specificity and sensitivity for the diagnosis of histoplasmosis in dogs.

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Comparison of International Federation of cervical pathology and colposcopy nomenclature (2011) and Swede score for assessment of cervical lesions

10.21203/rs.3.rs-169936/v1 ◽

2021 ◽

Author(s):

Bindiya Gupta ◽

Rashmi Shreya ◽

Shalini Rajaram ◽

Anshuja Singla ◽

Sandhya Jain ◽

...

Keyword(s):

Positive Predictive Value ◽

Prospective Study ◽

Negative Predictive Value ◽

Predictive Value ◽

Gold Standard ◽

International Federation ◽

Objective Method ◽

Cervical Lesions ◽

Sensitivity Specificity ◽

Strength Of Association

Abstract Purpose: Standardization of colposcopic evaluation is important as it is observer dependent.The aim of the study was to compare the strength of association of colposcopic findings by International Federation of Colposcopy and Cervical Pathology (IFCPC) nomenclature and Swede score. Methods: In the prospective study, 150 women aged 30 to 60 years with abnormal screening results underwent colposcopy, the findings were evaluated using both IFCPC and Swede score and biopsy was taken from abnormal areas. Performances by both the methods were calculated taking biopsy as gold standard. Results: Nineteen ≥ CIN2 lesions were detected. The sensitivity, specificity, positive predictive value and negative predictive value for detecting ≥ CIN2 lesion by IFCPC scoring was 63.6%, 96.0%, 78.7%, 91.9%. Using Swede score, sensitivity, specificity, positive predictive value and negative predictive value at cut off of 8 were 42.4, 95%, 96.6% and 81.8% while at cut-off of 5, these were 96%, 88.3%,76.7% and 93.6%. The agreement between IFCPC major lesion and Swede score ≥ 8 for ≥ CIN2 was 0.626 (p<0.01). Conclusion: Swede score is an easier and more objective method for colposcopic evaluation and a score >8 can be applied to the screen and treat programme.

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