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The value of radiographic markers in the diagnostic work-up of rotator cuff tears, an arthroscopic correlated study.
Skeletal Radiology ( IF 2.1 ) Pub Date : 2019-06-14 , DOI: 10.1007/s00256-019-03251-8 Jeroen J van der Reijden 1, 2 , Syert L Nienhuis 1 , Matthijs P Somford 3 , Michel P J van den Bekerom 4 , Job N Doornberg 5 , Esther van 't Riet 6 , Maaike P J van den Borne 7
Skeletal Radiology ( IF 2.1 ) Pub Date : 2019-06-14 , DOI: 10.1007/s00256-019-03251-8 Jeroen J van der Reijden 1, 2 , Syert L Nienhuis 1 , Matthijs P Somford 3 , Michel P J van den Bekerom 4 , Job N Doornberg 5 , Esther van 't Riet 6 , Maaike P J van den Borne 7
Affiliation
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.
中文翻译：
影像学标记物在肩袖撕裂的诊断检查中的价值，一项关节镜相关研究。
目的以关节镜作为参考标准，评估肩袖撕裂的诊断检查过程中的X线照片价值。材料与方法这项回顾性研究包括236例患者的236例肩膀。所有X线片均进行了皮质下肢顶动脉硬化症，肩峰外侧骨刺，肱骨头的上移，结节较大的囊肿和肩峰下空间钙化的评估。这些放射线征象在预测肩袖撕裂的预测价值是通过关节镜作为参考标准确定的。结果根据关节镜检查，诊断出131个肩部有肩袖撕裂。在131个肩部中，有72个（55％）患有下皮质肩峰硬化，37个（28％）肩峰外侧骨刺，21个（16％）肱骨头上移，7个（5％）结节性大囊肿和15个肩峰下空间钙化（11％）。下皮质肩峰硬化（P = 0.001），外侧骨刺（P = 0.001），上移（P = 0.002）和囊肿（P = 0.03）与肩袖撕裂显着且独立相关，而肩峰下钙化（p = 0.21） ） 不是。下皮质肩峰硬化，上移，肩峰外侧支和囊肿合起来具有78％的阳性预测价值。结论肩峰下部皮质硬化，肩峰外侧骨刺，肱骨头的良好迁移和结节性囊肿的结合对于全厚度肩袖撕裂的存在具有较高的阳性预测价值。根据影像学检查结果高度怀疑患有肩袖撕裂的患者，
更新日期：2019-06-14
中文翻译：
影像学标记物在肩袖撕裂的诊断检查中的价值，一项关节镜相关研究。
目的以关节镜作为参考标准，评估肩袖撕裂的诊断检查过程中的X线照片价值。材料与方法这项回顾性研究包括236例患者的236例肩膀。所有X线片均进行了皮质下肢顶动脉硬化症，肩峰外侧骨刺，肱骨头的上移，结节较大的囊肿和肩峰下空间钙化的评估。这些放射线征象在预测肩袖撕裂的预测价值是通过关节镜作为参考标准确定的。结果根据关节镜检查，诊断出131个肩部有肩袖撕裂。在131个肩部中，有72个（55％）患有下皮质肩峰硬化，37个（28％）肩峰外侧骨刺，21个（16％）肱骨头上移，7个（5％）结节性大囊肿和15个肩峰下空间钙化（11％）。下皮质肩峰硬化（P = 0.001），外侧骨刺（P = 0.001），上移（P = 0.002）和囊肿（P = 0.03）与肩袖撕裂显着且独立相关，而肩峰下钙化（p = 0.21） ） 不是。下皮质肩峰硬化，上移，肩峰外侧支和囊肿合起来具有78％的阳性预测价值。结论肩峰下部皮质硬化，肩峰外侧骨刺，肱骨头的良好迁移和结节性囊肿的结合对于全厚度肩袖撕裂的存在具有较高的阳性预测价值。根据影像学检查结果高度怀疑患有肩袖撕裂的患者，
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