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The value of radiographic markers in the diagnostic work-up of rotator cuff tears, an arthroscopic correlated study.

X线标记在肩袖撕裂诊断检查中的价值,一项关节镜相关研究。

  • 影响因子:1.50
  • DOI:10.1007/s00256-019-03251-8
  • 作者列表:"van der Reijden JJ","Nienhuis SL","Somford MP","van den Bekerom MPJ","Doornberg JN","van 't Riet E","van den Borne MPJ
  • 发表时间:2020-01-01
Abstract

OBJECTIVE:To evaluate the value of radiographs during the diagnostic work-up of rotator cuff tears, using arthroscopy as reference standard. MATERIALS AND METHODS:This retrospective study included 236 shoulders of 236 patients. All radiographs were evaluated for inferior cortical acromial sclerosis, lateral acromial spur, superior migration of the humeral head, greater tubercle cysts, and subacromial space calcifications. Predictive value of these radiographic signs in predicting rotator cuff tears was determined with arthroscopy as reference standard. RESULTS:According to arthroscopy, 131 shoulders were diagnosed with rotator cuff tears. Seventy-two out of 131 shoulders (55%) had inferior cortical acromial sclerosis, 37 (28%) lateral acromial spur, 21 (16%) superior migration of the humeral head, 7 (5%) greater tubercle cysts and 15 subacromial space calcifications (11%). Inferior cortical acromial sclerosis (P = 0.001), lateral spur (P = 0.001), superior migration (P = 0.002), and cysts (P = 0.03) were significantly and independently associated with rotator cuff tears, whereas subacromial calcifications (p = 0.21) was not. Inferior cortical acromial sclerosis, superior migration, lateral acromial spur, and cysts combined have a positive predictive value of 78%. CONCLUSIONS:The combination of inferior cortical acromial sclerosis, lateral acromial spur, superior migration of the humeral head, and greater tubercle cysts has a high positive predictive value for the presence of full-thickness rotator cuff tears. In patients with a high suspicion for having a rotator cuff tear based on radiographic findings, MRI can be performed directly without the delay and costs caused by an additional ultrasound exam.

摘要

目的: 以关节镜检查为参考标准,评价x线检查在肩袖撕裂诊断中的价值。 材料和方法: 本回顾性研究包括 236 例患者的 236 个肩。评价所有x线片的下皮质肩峰硬化、肩峰外侧骨刺、肱骨头上移、大结节囊肿和肩峰下间隙钙化。以关节镜检查为参考标准,确定这些影像学征象对预测肩袖撕裂的预测价值。 结果: 根据关节镜检查,131 的肩部诊断为肩袖撕裂。131 个肩关节中 72 个 (55%) 有下皮质肩峰硬化,37 个 (28%) 肩峰外侧骨刺,21 个 (16%) 肱骨头上移,7 个 (5%) 大结节囊肿和 15 个肩峰下间隙钙化 (11%)。下皮质肩峰硬化 (p = 0.001) 、侧骨刺 (p = 0.001) 、上移行 (p = 0.002) 和囊肿 (p = 0.03) 与肩袖撕裂显著独立相关,而肩峰下钙化 (p = 0.21) 无相关性。下皮质肩峰硬化、上移行、肩峰外侧骨刺、囊肿合并,阳性预测值为 78%。 结论: 合并下皮质肩峰硬化、肩峰外侧骨刺、肱骨头上移、大结节囊肿对全层肩袖撕裂的存在有很高的阳性预测值。根据影像学检查结果,高度怀疑肩袖撕裂的患者,可以直接进行MRI检查,而不会因额外的超声检查而造成延误和费用。

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发表时间:2020-01-01
DOI:10.1002/acr.23824
作者列表:["Chen SK","Liao KP","Liu J","Kim SC"]

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