Accuracy of clinical examination and magnetic resonance in assessment of chondral lesion of knee joint by arthroscopy

Introduction: The knee joint has a unique anatomical structure in the human body. The localization between the two longest bones in the human body – femur, and tibia – makes it prone to injuries, trauma, and other pathologies. Clinical examination of the joint is still the primary method in evaluating the condition of the patient's knee. The study aims to determine the diagnostic accuracy of clinical examination and magnetic resonance (MR) in assessing chondral lesions of knee joint using arthroscopy as a reference standard.Patients and methods: The examination was conducted on 94 patients (58 males and 36 females) with knee injuries. Clinical examination indicated a primary chondral lesion of knee cartilage in eight patients (five men and three women), with an average age of 45.75. Besides the clinical examination, the diagnostics were performed using MR imaging by Siemens of 0.5 Tesla, and arthroscopy was performed using Storz arthroscope.Results: Our research has generated the following values of clinical and MR results for chondral lesions: Sensitivity (Se) = 12.5%, Specificity (Sp): could not be calculated, Positive Predictive Value (PPV) = 100%, Negative Predictive Value (NPV) = 0% and Accuracy (ACC) = 12.5%. The accuracy of clinical and intraoperative results for chondral lesion was: Se =100%, Sp: could not be calculated, PPV = 100%, NPV: could not be calculated, and ACC = 100%. MR imaging and arthroscopy findings of chondral lesion showed: Se = 100%, Sp = 0%, PPV = 12.5%, NPV: could not be calculated and ACC = 12.5%. In comparing the clinical sign and MRand intraoperative result, Positive Predictive Value for patients with chondral lesion was maximal (100%), while comparing MR with the intraoperative result, Positive Predictive Value was 12.5%. In comparison between clinical sign and intraoperative results, the accuracy for patients with chondral lesion was 100%, while comparing the clinical sign with MR result and MR with the intraoperative result, the accuracy was 12.5%.Conclusion: Our examinations have shown that MR examination is not currently as valid for diagnosing injury of chondral cartilage of knee as the medical community or patients have anticipated it.

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Corrigendum to “Positive predictive value for diffusion-weighted magnetic resonance imaging in pediatric cholesteatoma: A retrospective study” [Int. J. Pediatr. Otorhinolaryngol. 2020, 139:110416. doi: 10.1016/j.ijporl.2020.110416. Epub 2020 Sep 30.PMID: 33027732]

International Journal of Pediatric Otorhinolaryngology ◽

10.1016/j.ijporl.2021.110692 ◽

2021 ◽

Vol 144 ◽

pp. 110692

Author(s):

Rémi Hervochon ◽

Monique Elmaleh ◽

Martine Francois ◽

Alix Marhic ◽

Abdullah Bahakim ◽

...

Keyword(s):

Magnetic Resonance Imaging ◽

Retrospective Study ◽

Magnetic Resonance ◽

Positive Predictive Value ◽

Predictive Value ◽

Resonance Imaging ◽

Diffusion Weighted ◽

Weighted Magnetic Resonance Imaging ◽

Pediatric Cholesteatoma

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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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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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Tele-Oncology: A Validation Study of Choroidal and Iris Nevi

Ocular Oncology and Pathology ◽

10.1159/000494977 ◽

2018 ◽

Vol 5 (4) ◽

pp. 298-302 ◽

Cited By ~ 3

Author(s):

Kelsey Roelofs ◽

Ezekiel Weis

Keyword(s):

Positive Predictive Value ◽

Standardized Tests ◽

Clinical Examination ◽

Validation Study ◽

Predictive Value ◽

Primary Study ◽

Standard Testing ◽

Common Diagnosis ◽

Sensitivity Specificity ◽

Growth Methods

Background/Aims: To evaluate teleophthalmological assessment of choroidal and iris nevi (tele-oncology) compared to traditional in-person clinical evaluation for detection of either axial or basal growth. Methods: This is a validation study. All 97 eyes of 99 patients were evaluated with an in-person ocular oncology visit utilizing standard testing, and subsequently had a tele-oncology evaluation with the standardized tests. The tele-oncology reviewer was blinded to the in-person examination findings. The primary study outcome was detection of nevus growth on tele-oncology compared to in-person clinical examination. Results: Patients had a mean age of 61 years and the majority had nevi located in the choroid (n = 87; 88%). The most common diagnosis was a low-risk nevus (n = 38; 44%). By tele-oncology assessment, 11 eyes showed growth. Ten of these patients had growth confirmed on in-person clinical examination. Resultantly, tele-oncology assessment of choroidal and iris nevi growth had a sensitivity of 100%, specificity of 99%, positive predictive value (PPV) of 91%, and negative predictive value (NPV) of 100%. Conclusions: The results of this study suggest that tele-oncology is a safe platform for monitoring choroidal and iris nevi for growth, with excellent sensitivity, specificity, PPV, and NPV.

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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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Role of MRI in the Diagnosis of Injury to the Lisfranc Ligament Complex

Foot & Ankle Orthopaedics ◽

10.1177/2473011418s00297 ◽

2018 ◽

Vol 3 (3) ◽

pp. 2473011418S0029

Author(s):

Christopher Kreulen ◽

Eric Giza ◽

Eva Escobedo ◽

Cyrus Bateni ◽

Michael Doherty

Keyword(s):

Magnetic Resonance ◽

Mr Imaging ◽

Negative Predictive Value ◽

Predictive Value ◽

High Sensitivity ◽

Lisfranc Injury ◽

Radiology Reports ◽

Lisfranc Ligament ◽

Sensitivity Specificity

Category: Sports Introduction/Purpose: Subtle Lisfranc ligamentous injuries are difficult to diagnose and magnetic resonance is becoming a useful tool. The purpose of this study is to evaluate the efficacy of magnetic resonance (MR) imaging for the diagnosis of injuries of the Lisfranc ligament complex. Methods: The radiology database was searched between Jan 1, 2010 and Mar 10, 2015 to identify patients over the age of 18 years who had MR imaging of the foot for suspected injury of the Lisfranc ligament complex. MR images were reviewed by 2 fellowship trained musculoskeletal radiologists, whom were blinded to the original radiology reports. Findings were categorized as: no injury or injury present. Injury was deemed to be present if 2 of the 3 components of C1-M2 ligament showed disruption or signal alterations on T1 and T2 weighted images. Disagreements were resolved by consensus. Correlation was made with surgical findings whenever performed. In patients not undergoing surgery, the presence or absence of injury was determined by clinical examination performed by an orthopedic surgeon and follow-up. Sensitivity, specificity, positive predictive value(PPV), and negative predictive value (NPV) of MR for diagnosis of Lisfranc ligament complex injury was determined. Results: Of 60 patients, 9 were excluded due to a lack of follow-up. Lisfranc injury was determined to be present on MR in 26 patients and 18 underwent surgery. Injury was confirmed in 16, and 2 were intact. 2 patients underwent closed reduction and were clinically determined to be injured. 6 of the injured 26 patients were sprained and not injured/torn on clinical evaluation. Of the 25 patients determined to have no injury on MR, 24 were intact clinically. 1 patient had a Lisfranc injury on follow-up. Sensitivity, specificity, PPV and NPV of MR for detection of significant Lisfranc injury were 94.7% (CI: 73.9% to 99.9%), 75% (CI: 56.6% to 88.5%), 69.2% (CI: 55% to 80.5%) and 96% (CI: 77.9% to 99.4%) respectively. Conclusion: MR has a high sensitivity and negative predictive value for diagnosis of injury to the Lisfranc ligament complex. MR of the foot should be considered in patients with clinical suspicion of injury to the Lisfranc ligament complex, and it is highly accurate in excluding such injuries.

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Isolated demyelinating syndromes: comparison of CSF oligoclonal bands and different MR imaging criteria to predict conversion to CDMS

Multiple Sclerosis Journal ◽

10.1177/135245850100700603 ◽

2001 ◽

Vol 7 (6) ◽

pp. 359-363 ◽

Cited By ~ 62

Author(s):

M Tintoré ◽

A Rovira ◽

L Brieva ◽

E Grivé ◽

R Jardí ◽

...

Keyword(s):

Mr Imaging ◽

Positive Predictive Value ◽

Negative Predictive Value ◽

Predictive Value ◽

High Sensitivity ◽

Oligoclonal Bands ◽

High Negative Predictive Value ◽

Csf Oligoclonal Bands ◽

Sensitivity Specificity

Aim of the study: To evaluate and compare the capacity of oligoclonal bands (OB) and three sets of MR imaging criteria to predict the conversion of clinically isolated syndromes (CIS) to clinically definite multiple sclerosis (CDMS). Patients and methods: One hundred and twelve patients with CIS were prospectively studied with MR imaging and determination of OB. Based on the clinical follow-up (conversion or not conversion to CDMS), we calculated the sensitivity, specificity accuracy, positive and negative predictive value of the OB, and MR imaging criteria proposed by Paty et al, Fazekas et al and Barkhof et al. Results: CDMS developed in 26 (23.2%) patients after a mean follow-up of 31 months (range 12-62). OB were positive in 70 (62.5%) patients and were associated with a higher risk of developing CDMS. OB showed a sensitivity of 81%, specificity of 43%, accuracy of 52%, positive predictive value (PPV) of 30% and negative predictive value (NPV) of 88%. Paty and Fazekas criteria showed the same results with a sensitivity of 77%, specificity of 51%, accuracy of 57%, positive predictive value of 32% and negative predictive value of 88%. Barkhof criteria showed a sensitivity of 65%, specificity of 70%, accuracy of 69%, PPV of 40% and NPV of 87%. The greatest accuracy was achieved when patients with positive OB and three or four Barkhof's criteria were selected. Conclusions: We observed a high prevalence of OB in CIS. OB and MR imaging (Paty's and Fazekas' criteria) have high sensitivity. Barkhof's criteria have a higher specificity. Both OB and MR imaging criteria have a high negative predictive value.

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Predictive Value of 3-T Magnetic Resonance Imaging in Diagnosing Grade 3 and 4 Chondral Lesions in the Hip

Arthroscopy The Journal of Arthroscopic and Related Surgery ◽

10.1016/j.arthro.2016.03.014 ◽

2016 ◽

Vol 32 (9) ◽

pp. 1808-1813 ◽

Cited By ~ 10

Author(s):

Charles P. Ho ◽

N. Dawn Ommen ◽

Sanjeev Bhatia ◽

Adriana J. Saroki ◽

Peter Goljan ◽

...

Keyword(s):

Magnetic Resonance Imaging ◽

Magnetic Resonance ◽

Predictive Value ◽

Resonance Imaging ◽

Chondral Lesions ◽

Grade 3

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Hildreth’s Test is a Reliable Clinical Sign for the Diagnosis of Glomus Tumours

Journal of Hand Surgery (European Volume) ◽

10.1054/jhsb.2001.0724 ◽

2002 ◽

Vol 27 (2) ◽

pp. 157-158 ◽

Cited By ~ 29

Author(s):

H. GIELE

Keyword(s):

Positive Predictive Value ◽

Negative Predictive Value ◽

Clinical Sign ◽

Predictive Value ◽

Clinical Test

Hildreth’s test is a clinical test for the diagnosis of glomus tumours. It is positive if there is a reduction in pain and tenderness on exsanguination and ischaemia of the affected part. This study assessed Hildreth’s test, and found 92% sensitivity and 91% specificity with a positive predictive value of 92% and a negative predictive value of 91%.

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