scholarly journals Dynamic Ultrasonographic Measurement of Inferior Joint Cap-Sule Thickness in Patients with Unilateral Frozen Shoulder

Diagnostics ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. 898
Author(s):  
Jun-Gyu Lee ◽  
Hyung-Sun Peo ◽  
Jang-Hyuk Cho ◽  
Chul-Hyun Cho ◽  
Don-Kyu Kim ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Glenohumeral Joint ◽  
Frozen Shoulder ◽  
Area Under The Curve ◽  
Diagnostic Value ◽  
Neutral Position ◽  
Anterior Axillary Line ◽  
Linear Transducer ◽  
The Us ◽  
Good Diagnostic Accuracy

The diagnostic value of ultrasonography (US) for frozen shoulder (FS) is not well established. This study aimed to assess the diagnostic value of US measurement of inferior joint capsule (IJC) thickness and evaluate changes in the thickness of the IJC by US depending on arm position. A total of 71 patients with clinically diagnosed unilateral FS who underwent bilateral US measurement of the IJC were enrolled in this study. The US measurement of the IJC was performed with a linear transducer positioned around the anterior axillary line with the shoulder 40° abducted and with neutral rotation of the glenohumeral joint (neutral position). We also measured the IJC thickness in the externally rotated and internally rotated positions with the shoulder 40° abducted. In the neutral position, as well as in the internally rotated and externally rotated positions, the thickness of the IJC on US was significantly higher in the affected shoulder than that in the unaffected shoulder (all p < 0.001). On both the affected and unaffected sides, the US thickness of the IJC in the neutral position was significantly higher than that in the externally rotated position (p < 0.001), but lower than that in the internally rotated position (p < 0.001). Regarding IJC thickness in the neutral position, a 3.2-mm cutoff value yielded the highest diagnostic accuracy for FS, with a sensitivity and specificity of 73.2% and 77.5%, respectively. The area under the curve for IJC thickness was 0.824 (95% confidence interval, 0.76–0.89). US measurement of the IJC in the neutral position yielded good diagnostic accuracy for FS. Because IJC thickness is affected by arm rotation, it is important to measure the IJC thickness in a standardized posture to ensure diagnostic value.

Value of Fibrinogen to Discriminate Appendicitis from Nonspecific Abdominal Pain in Preschool Children

2019 ◽  
Vol 30 (04) ◽  
pp. 357-363
Author(s):  
Javier Gómez-Veiras ◽  
Ángel Salgado-Barreira ◽  
José Luis Vázquez ◽  
Margarita Montero-Sánchez ◽  
José Ramón Fernández-Lorenzo ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Preschool Children ◽  
Diagnostic Accuracy ◽  
Prothrombin Time ◽  
Characteristic Curve ◽  
Area Under The Curve ◽  
Diagnostic Value ◽  
Suspected Appendicitis ◽  
Uncomplicated Appendicitis ◽  
Good Diagnostic Accuracy

Introduction The aim of this study was to assess the diagnostic value of the biomarker fibrinogen (FB), along with the markers white blood cell (WBC) count, absolute neutrophil count (ANC), and C-reactive protein (CRP), to discriminate appendicitis from nonspecific abdominal pain (NSAP) in preschool children. Materials and Methods We prospectively evaluated all children aged <5 years admitted for suspected appendicitis at an academic pediatric emergency department during 5 years. Diagnostic accuracy of FB (prothrombin time–derived method), WBC, ANC, and CRP were assessed by the area under the curve (AUC) of the receiver-operating characteristic curve. Results A total of 82 patients were enrolled in the study (27 NSAP, 17 uncomplicated, and 38 complicated appendicitides). WBC and ANC had moderate diagnostic accuracy for appendicitis versus NSAP (WBC: AUC 0.66, ANC: AUC 0.67). CRP and FB had good diagnostic accuracy for appendicitis versus NSAP (CRP: AUC 0.78, FB: AUC 0.77). WBC and ANC are not useful to discriminate complicated versus uncomplicated appendicitis (WBC: AUC 0.43, ANC: AUC 0.45). CPR and FB had good diagnostic accuracy for complicated versus uncomplicated appendicitis (CRP: AUC 0.80, FB: AUC 0.73). Conclusion CRP and FB are more useful than WBC and ANC to discriminate appendicitis from NSAP in preschool children. CRP and FB are especially useful to discriminate complicated from uncomplicated appendicitis and NSAP. In a child with suspected appendicitis, a plasma FB level (prothrombin time–derived method) >540 mg/dL is associated with an increased likelihood of complicated appendicitis.

scholarly journals Diagnostic Value of High-resolution Ultrasound for the Evaluation of Capsular Distension in Temporomandibular Joint Effusion

2021 ◽  
Author(s):  
Daniel Talmaceanu ◽  
Lavinia ◽  
Csaba Csutak ◽  
Nicolae Bolog ◽  
Daniel Leucuta ◽  
...  
Keyword(s):  
Temporomandibular Joint ◽  
Roc Curve ◽  
Temporomandibular Disorders ◽  
Signs And Symptoms ◽  
Diagnostic Value ◽  
Joint Effusion ◽  
Mri Imaging ◽  
Linear Transducer ◽  
Indirect Sign ◽  
The Us

Abstract Objectives. The aim of this study was to evaluate if the increased temporomandibular joint (TMJ) capsular thickness, measured by ultrasound (US), is associated with the presence of effusion, diagnosed using MRI imaging.Methods. 102 patients with signs and symptoms of temporomandibular disorders were included in the study. Each patient underwent US and MRI examination, 1 to 7 days following clinical examination. The US was performed with an 8–40 MHz linear transducer operating at 20 MHz. MRI was performed using an 1.5 T MRI device. The ROC curve was analyzed to identify the optimal cut-off value for capsular distention, which can be used as an indirect sign of TMJ effusion.Results. The capsular width values were found to be between 0.7-3.6mm. The best cut-off value was 2.05 mm with sensitivity of 55.9% and specificity of 94.7% (p<0.05). The next optimal cut-off value was 1.75 mm with sensitivity of 67.6% and specificity of 82.4%. The area under the ROC curve was 0.78 (95 % CI 0.68, 0.87). Conclusions. Ultrasound measured capsular width can be used as an indirect sign of TMJ effusion. The most accurate cut-off value obtained in this study was 2.05 mm.

scholarly journals Diagnostic value of endobronchial ultrasound elastography for differentiating benign and malignant hilar and mediastinal lymph nodes: a systematic review and meta-analysis

2021 ◽  
Author(s):  
Jiangfeng Wu ◽  
Yue Sun ◽  
Yunlai Wang ◽  
Lijing Ge ◽  
Yun Jin ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Likelihood Ratio ◽  
Meta Analysis ◽  
Area Under The Curve ◽  
Positive Likelihood Ratio ◽  
Negative Likelihood Ratio ◽  
Diagnostic Value ◽  
Endobronchial Ultrasound ◽  
Mediastinal Lymph Nodes ◽  
Sensitivity Specificity

Aims: In the present study, a meta-analysis was performed to evaluate the diagnostic value of endobronchial ultrasound (EBUS) elastography for differentiating benign and malignant hilar and mediastinal lymph nodes (LNs). Material and methods: A comprehensive literature search was carried out through PubMed, Embase, and Cochrane Library. Two authors screened the papers and extracted the data independently and any discrepancies were resolved by discussion. The methodolog-ical quality of each included study was assessed by the Quality Assessment of Diagnostic Accuracy Studies 2 tool. Sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, and area under the curve were calculated to evaluate the value of EBUS elastography for hilar and mediastinal LNs. Results: Seventeen studies with the number of 2307 LNs were included. There was significant heterogeneity across the included studies. The pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio and diagnostic odds ratio for the diagnosis of hilar and mediastinal LNs by EBUS elastography were 0.90 (95% confidence interval [CI], 0.84-0.94), 0.78 (95% CI, 0.74-0.81), 4.1 (95% CI, 3.4-4.9), 0.12 (95% CI, 0.07-0.21) and 33 (95% CI, 17-64), respectively. Furthermore, area under the curve was calculated to be 0.86 (95% CI, 0.82-0.88). Conclusion: EBUS elastography is a valuable technology in the differentiation of benign and malignant hilar and mediastinal LNs and could provide supplementary diagnostic information during endobronchial ultrasound-guided transbronchial needle aspiration. The combination of EBUS elastography and B-mode EBUS could improve the diagnostic accuracy for hilar and mediastinal LNs.

A prospective double-blind randomized trial on ultrasound-guided versus blind intra-articular corticosteroid injections for primary frozen shoulder

2021 ◽  
Vol 103-B (2) ◽  
pp. 353-359
Author(s):  
Chul-Hyun Cho ◽  
Byung-Woo Min ◽  
Ki-Cheor Bae ◽  
Kyung-Jae Lee ◽  
Du Hwan Kim
Keyword(s):  
Glenohumeral Joint ◽  
External Rotation ◽  
Frozen Shoulder ◽  
Range Of Movement ◽  
Double Blind ◽  
Pain Scores ◽  
The Us ◽  
Time Of Presentation ◽  
Corticosteroid Injections

Aims Ultrasound (US)-guided injections are widely used in patients with conditions of the shoulder in order to improve their accuracy. However, the clinical efficacy of US-guided injections compared with blind injections remains controversial. The aim of this study was to compare the accuracy and efficacy of US-guided compared with blind corticosteroid injections into the glenohumeral joint in patients with primary frozen shoulder (FS). Methods Intra-articular corticosteroid injections were administered to 90 patients primary FS, who were randomly assigned to either an US-guided (n = 45) or a blind technique (n = 45), by a shoulder specialist. Immediately after injection, fluoroscopic images were obtained to assess the accuracy of the injection. The outcome was assessed using a visual analogue scale (VAS) for pain, the American Shoulder and Elbow Surgeons (ASES) score, the subjective shoulder value (SSV) and range of movement (ROM) for all patients at the time of presentation and at three, six, and 12 weeks after injection. Results The accuracy of injection in the US and blind groups was 100% (45/45) and 71.1% (32/45), respectively; this difference was significant (p < 0.001). Both groups had significant improvements in VAS pain score, ASES score, SSV, forward flexion, abduction, external rotation, and internal rotation throughout follow-up until 12 weeks after injection (all p < 0.001). There were no significant differences between the VAS pain scores, the ASES score, the SSV and all ROMs between the two groups at the time points assessed (all p > 0.05). No injection-related adverse effects were noted in either group. Conclusion We found no significant differences in pain and functional outcomes between the two groups, although an US-guided injection was associated with greater accuracy. Considering that it is both costly and time-consuming, an US-guided intra-articular injection of corticosteroid seems not always to be necessary in the treatment of FS as it gives similar outcomes as a blind injection. Cite this article: Bone Joint J 2021;103-B(2):353–359.

scholarly journals Multivariate Spatial Covariance Analysis of 99MTc-Exametazime SPECT Images in Dementia with Lewy Bodies and Alzheimer'S Disease: Utility in Differential Diagnosis

2013 ◽  
Vol 33 (4) ◽  
pp. 612-618 ◽  
Author(s):  
Sean J Colloby ◽  
John-Paul Taylor ◽  
Christopher M Davison ◽  
Jim J Lloyd ◽  
Michael J Firbank ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Blood Flow ◽  
Diagnostic Accuracy ◽  
Dementia With Lewy Bodies ◽  
Lewy Bodies ◽  
Diagnostic Value ◽  
Covariance Analysis ◽  
Spatial Covariance ◽  
Good Diagnostic Accuracy ◽  
Spect Images

We examined 99mTc-exametazime brain blood flow single-photon emission computed tomography (SPECT) images using a spatial covariance analysis (SCA) approach to assess its diagnostic value in distinguishing dementia with Lewy bodies (DLB) from Alzheimer's disease (AD). Voxel SCA was simultaneously applied to a set of preprocessed images (AD, n = 40; DLB, n = 26), generating a series of eigenimages representing common intercorrelated voxels in AD and DLB. Linear regression derived a spatial covariance pattern (SCP) that discriminated DLB from AD. To investigate the diagnostic value of the model SCP, the SCP was validated by applying it to a second, independent, AD and DLB cohort (AD, n = 34; DLB, n = 29). Mean SCP expressions differed between AD and DLB ( F1,64 = 36.2, P < 0.001) with good diagnostic accuracy (receiver operating characteristic (ROC) curve area 0.87, sensitivity 81%, specificity 88%). Forward application of the model SCP to the independent cohort revealed similar differences between groups (F1,61 = 38.4, P < 0.001), also with good diagnostic accuracy (ROC 0.86, sensitivity 80%, specificity 80%). Multivariate analysis of blood flow SPECT data appears to be robust and shows good diagnostic accuracy in two independent cohorts for distinguishing DLB from AD.

scholarly journals Inflammatory Breast Carcinoma: Elevated microRNA miR-181b-5p and Reduced miR-200b-3p, miR-200c-3p, and miR-203a-3p Expression as Potential Biomarkers with Diagnostic Value

Biomolecules ◽  
2020 ◽  
Vol 10 (7) ◽  
pp. 1059
Author(s):  
Sarah Atef Fahim ◽  
Mahmoud Salah Abdullah ◽  
Nancy A. Espinoza-Sánchez ◽  
Hebatallah Hassan ◽  
Ayman M. Ibrahim ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Diagnostic Accuracy ◽  
Operating Characteristic ◽  
Area Under The Curve ◽  
Roc Curves ◽  
Diagnostic Value ◽  
Differentially Expressed Mirnas ◽  
E Box ◽  
Aggressive Breast Cancer ◽  
Potential Biomarkers

Inflammatory breast cancer (IBC) is a rare yet aggressive breast cancer variant, associated with a poor prognosis. The major challenge for IBC is misdiagnosis due to the lack of molecular biomarkers. We profiled dysregulated expression of microRNAs (miRNAs) in primary samples of IBC and non-IBC tumors using human breast cancer miRNA PCR array. We discovered that 28 miRNAs were dysregulated (10 were upregulated, while 18 were underexpressed) in IBC vs. non-IBC tumors. We identified 128 hub genes, which are putative targets of the differentially expressed miRNAs and modulate important cancer biological processes. Furthermore, our qPCR analysis independently verified a significantly upregulated expression of miR-181b-5p, whereas a significant downregulation of miR-200b-3p, miR-200c-3p, and miR-203a-3p was detected in IBC tumors. Receiver operating characteristic (ROC) curves implied that the four miRNAs individually had a diagnostic accuracy in discriminating patients with IBC from non-IBC and that miR-203a-3p had the highest diagnostic value with an AUC of 0.821. Interestingly, a combination of miR-181b-5p, miR-200b-3p, and miR-200c-3p robustly improved the diagnostic accuracy, with an area under the curve (AUC) of 0.897. Intriguingly, qPCR revealed that the expression of zinc finger E box-binding homeobox 2 (ZEB2) mRNA, the putative target of miR-200b-3p, miR-200c-3p, and miR-203a-3p, was upregulated in IBC tumors. Overall, this study identified a set of miRNAs serving as potential biomarkers with diagnostic relevance for IBC.

Evaluation of Serum GDF15, AFP, and PIVKA-II as Diagnostic Markers for HBV-Associated Hepatocellular Carcinoma

2020 ◽  
Author(s):  
Juanjuan Chen ◽  
Dongling Tang ◽  
Chu Xu ◽  
Zhili Niu ◽  
Huan Li ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Hepatitis B ◽  
Diagnostic Accuracy ◽  
Roc Curve ◽  
Operating Characteristic ◽  
Area Under The Curve ◽  
Serum Levels ◽  
Diagnostic Value ◽  
Serum Marker ◽  
B Virus

Abstract Objective To evaluate the potential diagnostic value of growth differentiation factor 15 (GDF15) alone and its combination with protein induced by vitamin K absence-II (PIVKA-II) and alpha-fetoprotein (AFP) for hepatitis B virus (HBV)-associated hepatocellular carcinoma (HCC). Methods Serum levels of GDF15, PIVKA-II, and AFP were measured in 110 patients with HBV-associated HCC, 70 patients with HBV-related liver cirrhosis (LC), 70 patients with chronic hepatitis B (CHB), and 110 healthy patients. Results Serum GDF15 was positively related to the levels of PIVKA-II and AFP in patients with HCC (r = 0.352 and r = 0.378; all P &lt;.0001). When the receiver operating characteristic (ROC) curve was plotted for patients with HCC vs all control patients, serum GDF15 had diagnostic parameters of an area under the curve (AUC) of 0.693, a sensitivity of 67.30%, and a specificity of 66.70%, which were lower than parameters for PIVKA-II and AFP (all P &lt;.0001). When the ROC curve was plotted for patients with HCC vs patients with LC, the combination of GDF15 and PIVKA-II had the highest diagnostic accuracy of AUC and specificity as compared with other combinations (all P &lt;.0001). Conclusion We found that GDF15 is a potent serum marker for the detection of HBV-associated HCC and that PIVKA-II combined with GDF15 can improve diagnostic accuracy for HBV-associated HCC.

scholarly journals MicroRNAs as Biomarkers for the Diagnosis of Ankylosing Spondylitis: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 8 ◽  
Author(s):  
Jiangbi Li ◽  
Xiaoping Xie ◽  
Weibing Liu ◽  
Feng Gu ◽  
Ke Zhang ◽  
...  
Keyword(s):  
Ankylosing Spondylitis ◽  
Diagnostic Accuracy ◽  
Likelihood Ratio ◽  
Meta Analysis ◽  
Area Under The Curve ◽  
Positive Likelihood Ratio ◽  
Negative Likelihood Ratio ◽  
Diagnostic Odds Ratio ◽  
Good Diagnostic Accuracy ◽  
Sensitivity Specificity

Background: Abnormal expression levels of microRNAs (miRNAs) were observed in ankylosing spondylitis (AS) in recent articles, suggesting that miRNAs may be used as biomarkers for AS diagnoses. In this paper, we conducted a meta-analysis to identify the overall diagnostic accuracy of miRNA biomarkers in AS patients.Methods: An extensive search was undertaken in PubMed, Embase, Cochrane databases, and Wan Fang database up to 30 December 2020 using the following key words: (“microRNAs” or “microRNA” or “miRNA” or “miR” or “RNA, Micro” or “Primary MicroRNA”) and (“Spondylitis Ankylosing” or “Spondyloarthritis Ankylopoietica” or “Ankylosing Spondylarthritis” or “Ankylosing Spondylarthritides” or “Spondylarthritides Ankylosing” or “Ankylosing Spondylitis”) and (“blood” or “serum” or “plasma”). Statistical evaluation of dysregulated miRNAs using the sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR), and the area under the curve (AUC).Results: Twenty-nine articles reporting on the miRNAs of AS were included. A total of 42 miRNAs were observed to be up-regulated and 45 miRNAs were down-regulated in the AS cases compared with the controls. Besides, 29 studies from nine articles were included in our meta-analysis. The pooled sensitivity, specificity, PLR, NLR, DOR, and AUC were 0. 76 (95% CI, 0.70–0.81), 0.80 (95% CI, 0.74–0.85), 3.75 (95% CI, 2.82–5.01), 0.30 (95% CI, 0.24–0.39), 12.32 (95% CI, 7.65–19.83), 0.85 (95% CI, 0.81–0.88), respectively, suggesting a good diagnostic accuracy of miRNAs for AS.Conclusions: Circulating miRNAs are deregulated in AS patients. miRNAs may be used as a relatively non-invasive biomarkers for the detection of AS.

scholarly journals Diagnostic Accuracy of Immunologic Biomarkers for Accurate Diagnosis of Bloodstream Infection in Patients with Malignancy: Procalcitonin in Comparison with C-Reactive Protein

2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Mansoureh Shokripour ◽  
Navid Omidifar ◽  
Kourosh Salami ◽  
Mohsen Moghadami ◽  
Babak Samizadeh
Keyword(s):  
Blood Culture ◽  
Diagnostic Accuracy ◽  
Area Under The Curve ◽  
Reference Method ◽  
Diagnostic Value ◽  
Clinical Suspicion ◽  
Accurate Diagnosis ◽  
C Reactive Protein ◽  
Cutoff Value ◽  
Reactive Protein

Purpose. To calculate the diagnostic value of C-reactive protein (CRP) and serum procalcitonin (PCT) levels for the pathologic presence of microbes in the bloodstream of patients with malignancy, in comparison with blood culture. Methodology. Blood culture (by reference method) and assay results of PCT and CRP of febrile patients, with clinical suspicion to blood infections, were collected. Statistical aspects of PCT  and CRP tests were evaluated. Results. Data from 255 cases were gathered. The area under the curve for differentiating bacteremia from nonbacteremia for PCT (0.741) was superior to that of CRP (0.612). Amongst the different cutoffs of PCT and CRP, the cutoff of ≥1.17 ng/ml and >47 mg/l had the sensitivity of 75 and 58.3%, the best NPV of 91.5% and 81.3%, and the best specificity of 79.9% and 72.8%, respectively. Discussion. Despite statistically nonsignificant results, PCT seems to be a superior indicator to CRP for rejecting the presence of microorganism in bloodstream. For PCT, the cutoff value of 1.17 ng/ml (bacteremia from nonbacteremia) had the highest NPV value of 91.5% in malignant patients, suspicion of sepsis.

scholarly journals The Preoperative Diagnostic Value of MRI and Otoneural Tests in Acoustic Neuroma

2021 ◽  
Vol 11 ◽  
Author(s):  
Qingqing Dai ◽  
Meijun Zheng ◽  
Qiurong Chen ◽  
Hong Zheng ◽  
Bilan Li
Keyword(s):  
Diagnostic Accuracy ◽  
Acoustic Neuroma ◽  
Early Stage ◽  
Internal Auditory Canal ◽  
Area Under The Curve ◽  
Diagnostic Value ◽  
Preoperative Diagnostic ◽  
Optimal Screening ◽  
Accuracy Study ◽  
Pontocerebellar Angle Tumors

ObjectivesTo determine the preoperative diagnostic accuracy of MRI and otoneural tests (ONT) for acoustic neuroma (AN) in a cohort of unselected patients with pontocerebellar angle tumors. To find a convenient way to screening out the potential asymptomatic AN patient earlier.DesignThis diagnostic accuracy study was performed in a central hospital and included a consecutive sample of unilateral incipient pontocerebellar angle tumor patients referred for MRI and ONT before surgery. Different AN features of MRI and ONT were collected and concluded into preoperative diagnostic variables or variable combinations. Those of MRI and ONT are analyzed and compared with biopsy results by multivariable receiver operating characteristic (ROC) analysis. The early-stage group, the course of which is 1 year or less, was separately computed and compared.ResultsEighty-three subjects were collected from June 2013 to June 2019; 62 were confirmed AN postoperatively by biopsy, whereas others are not AN. The area under the curve (AUC) of MRI was 0.611, whereas the AUC of ONT was 0.708. In the early-stage group, the AUC of MRI was 0.539, and the AUC of ONT was 0.744.ConclusionsONT was able to identify more subjects affected by unilateral incipient AN than MRI preoperatively. Given that ONT is a functional test for internal auditory canal nerves, it is an optimal screening test for AN patients because it provides more information than MRI for the further clinical plan. It is particularly noteworthy for identifying asymptomatic AN patients and for early stage. Therefore, it may help more patients from unnessesary surgery. Furthermore, an MRI follow-up is suggested if the patient was found alert in ONT.

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