Correlation between clinical, MRI and arthroscopic findings in various shoulder joint disorders
DOI:
https://doi.org/10.18203/issn.2455-4510.IntJResOrthop20253420Keywords:
Arthroscopy, Clinical examination, MRI, Shoulder jointAbstract
Background: Shoulder joint is the most freely moveable, but a relatively unstable joint in the body. The most commonly used currently prevalent diagnostic tools for shoulder joint disorders are clinical examination, Magnetic Resonant Imaging (MRI) and the gold standard arthroscopy. All have their inherent advantages and disadvantages and none is an all-inclusive tool. Furthermore, the current literature lacks studies comparing all the three diagnostic tools together or has just included one or two of the wide array of shoulder joint disorders. Therefore, this study was undertaken to identify correlation between all three diagnostic methods in arriving at a diagnosis in various shoulder disorders taking arthroscopy as a gold standard.
Methods: The study was a prospective descriptive study carried out at a tertiary care hospital over period of 2 years. 33 symptomatic shoulder patients underwent standardized history, physical examination and MRI prior to diagnostic/therapeutic arthroscopy procedure. Shoulder arthroscopy considered as the gold standard, was used as a benchmark for comparing and confirming the results of clinical and radiological findings using the standard statistical data analysis.
Results: Amongst clinical and radiological (MRI) findings; clinical examination was found to be superior to MRI in diagnosing adhesive capsulitis and bicipital tendinitis; MRI was found to be superior to clinical examination for diagnosing rotator cuff tears and Gleno-Humeral (GH) arthritis; both were equivocal in diagnosing Sub-Acromial Impingement Syndrome (SAIS), GH instability and Superior Labrum Anterior Posterior (SLAP) lesions.
Conclusions: No modality in isolation is accurate and a combination of various available diagnostic tools gives the best precision in diagnosing shoulder joint disorders.
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References
Quillen DM, Wuchner M, Hatch RL. Acute shoulder injuries. Am Fam Physician. 2004;70(10):1947-54.
Tirman PF, Seinbach LS, Belzer JP, Bost FW. A practical approach to imaging the shoulder with emphasis on MR imaging. Orthopaed Clin North America. 1997;28(4):483-515. DOI: https://doi.org/10.1016/S0030-5898(05)70306-0
Nam EK, Snyder SJ. The diagnosis and treatment of superior labrum, anterior and posterior (SLAP) lesions. American J Sports Med. 2003;31(5):798810. DOI: https://doi.org/10.1177/03635465030310052901
Ben Kibler W, Sciascia AD, Hester P. Clinical utility of traditional and new tests in the diagnosis of biceps tendon injuries and superior labrum anterior and posterior lesions in the shoulder. Am J Sports Med. 2009;37:1840-7. DOI: https://doi.org/10.1177/0363546509332505
Somerville LE, Willits K, Johnson AM, Litchfield R, LeBel ME. Clinical Assessment of Physical Examination Maneuvers for Rotator Cuff Lesions. Am J Sports Med. 2014;42(8):1911-9. DOI: https://doi.org/10.1177/0363546514538390
MacDonald PB, Clark P, Sutherland K. An analysis of the diagnostic accuracy of the Hawkins and Neer impingement tests. J Shoulder Elbow Surg. 2000;9(4):299–301. DOI: https://doi.org/10.1067/mse.2000.106918
Hegedus EJ, Goode AP, Cook CE. Which physical examination tests provide clinicians with the most value when examining the shoulder. Update of a systematic review with meta-analysis of individual tests. Br J Sports Med. 2012;46:964-78. DOI: https://doi.org/10.1136/bjsports-2012-091066
Lesniak BP, Baraga MG, Jose J, Smith MK, Cunningham S, Kaplan LD. Glenohumeral findings on magnetic resonance imaging correlate with innings pitched in asymptomatic pitchers. Am J Sports Med. 2013;41:2022-2027. DOI: https://doi.org/10.1177/0363546513491093
Joshi UP, Puri S. Clinical, MRI and arthroscopic correlation in anterior and posterior shoulder instability. Int J Res Med Sci. 2014;2:857-60. DOI: https://doi.org/10.5455/2320-6012.ijrms20140813
Farber AJ, Castillo R, Clough M. Clinical assessment of three common tests for traumatic anterior shoulder instability. J Bone Joint Surg Am. 2006;88:1467-74. DOI: https://doi.org/10.2106/JBJS.E.00594
Stetson WB, Templin K. The crank test, the O'Brien test and routine magnetic resonance imaging scans in the diagnosis of labral tears. Am J Sports Med. 2002;30(6):806-9. DOI: https://doi.org/10.1177/03635465020300060901
Momenzadeh OR, Gerami MH, Sefidbakht S, Dehghani S. Assessment of Correlation between MRI and Arthroscopic Findings in Shoulder Joint. Arch Bone Jt Surg. 2015;3(4):286–90.
Bhatnagar A, Bhonsle S, Mehta S. Correlation between MRI and Arthroscopy in Diagnosis of Shoulder Pathology. J Clin Diagn Res. 2016;10(2):18–21. DOI: https://doi.org/10.7860/JCDR/2016/14867.7309
Ringshawl ZY, Bhat AA, Bashir Z, Farooq M, Wani MM. Correlation between the Findings of MRI Shoulder and Shoulder Arthroscopy. J Clin Diagn Res. 2020;14(9):5-10. DOI: https://doi.org/10.7860/JCDR/2020/44557.14048
Malhi AM, Khan R. Correlation between clinical diagnosis and arthroscopic findings of the shoulder. Postgraduate Med J. 2005;81(960):657–9. DOI: https://doi.org/10.1136/pgmj.2004.030254
Sabharwal T, Khanduri S, Khan S. A comparative assessment between high resolution ultrasonography and field magnetic resonance imaging in supraspinatus tear cases and its arthroscopic correlation. Cureus. 2019;11(9):5627. DOI: https://doi.org/10.7759/cureus.5627
Carr RM, Shishani Y, Gobezie R. How Accurate Are We in Detecting Biceps Tendinopathy. Clin Sports Med. 2016;35(1):47-55. DOI: https://doi.org/10.1016/j.csm.2015.08.002
Iqbal HJ, Rani S, Mahmood A, Brownson P, Aniq H. Diagnostic value of MR arthrogram in SLAP lesions of the shoulder. Surgeon. 2010;8:303-9. DOI: https://doi.org/10.1016/j.surge.2010.06.006
Manske RC, Prohaska D. Diagnosis and management of adhesive capsulitis. Curr Rev Musculoskelet Med. 2008;1(4):180-9. DOI: https://doi.org/10.1007/s12178-008-9031-6
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