Jensen J, Kristensen MT, Bak L, Kristensen SS, Graumann O. MR arthrography of the shoulder; correlation with arthroscopy.
Acta Radiol Open 2021;
10:20584601211062059. [PMID:
34881048 PMCID:
PMC8646798 DOI:
10.1177/20584601211062059]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Accepted: 11/07/2021] [Indexed: 11/16/2022] Open
Abstract
Background
Shoulder dislocation is a common injury, particularly in the younger population. Common
long-term sequelae include pain, recurrence, and shoulder arthritis. Immediate and
correct diagnosis following shoulder dislocation is key to achieving optimum outcomes.
Although magnetic resonance arthrography (MRA) is frequently used for diagnosing
shoulder instabilities, arthroscopy is still considered the gold standard.
Purpose
This study aims to compare the diagnostic value of arthroscopy and MRA of the shoulder
joint.
Materials and methods
This retrospective study estimates the sensitivity and specificity of MRA of the
shoulder. Data from patients who had undergone shoulder MRA and subsequent arthroscopy
during a 5-year period were retrospectively collected. Sensitivity and specificity were
calculated using the arthroscopic findings as the gold standard. Moreover, diagnostic
accuracy was estimated using McNemar’s test.
Results
In total, 205 cases were included from which 372 pathological findings were uncovered
during the arthroscopic procedures as opposed to 360 findings diagnosed from the MRA
images. The glenoid labral tear was the most common finding reported by MRA and
arthroscopy. For the detection of glenoid labral tears on MRA, the sensitivity was 0.955
but with eight missed lesions; the specificity was 0.679. Capsular tears, rotator cuff
tears, and cartilage lesions proved the most difficult to correctly diagnose using MRA
with sensitivities of 0.2, 0.346, and 0.366, respectively.
Conclusions
With a sensitivity of 95%, MRA is a valuable diagnostic tool for assessing shoulder
instabilities, particularly when diagnosing labral lesions, including bony and
soft-tissue Bankart lesions. Sensitivities and specificities for other glenohumeral
lesions are less convincing, however.
Collapse