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A comparison of magnetic resonance arthrography and arthroscopic findings in the assessment of anterior shoulder dislocations.

Jordan, R W and Naeem, R and Srinivasan, K and Shyamalan, G (2015) A comparison of magnetic resonance arthrography and arthroscopic findings in the assessment of anterior shoulder dislocations. Skeletal radiology, 44 (5). pp. 653-7. ISSN 1432-2161. This article is accessible to all HEFT staff and students via NICE journals and databases http://www.nice.org.uk/about/what-we-do/evidence-services/journals-and-databases by using their HEFT Athens login IDs

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Official URL: http://link.springer.com/article/10.1007%2Fs00256-...

Abstract

OBJECTIVE

The aim of this study is to establish the sensitivity and specificity of MRA in the investigation of patients with traumatic anterior shoulder dislocations.

MATERIALS AND METHODS

A retrospective analysis of consecutive patients undergoing both magnetic resonance arthrography and arthroscopic assessment after a traumatic anterior shoulder dislocation between January 2011 and 2014 was performed. Demographic data were collected from electronic records. Images were interpreted by 8 musculoskeletal radiologists and patients were treated by 8 consultant orthopaedic surgeons. Arthroscopic findings were obtained from surgical notes and these findings were used as a reference for MRA. The sensitivity, specificity, and positive predictive value were calculated for the different injuries.

RESULTS

Sixty-nine patients underwent both an MRA and shoulder arthroscopy during the study period; however, clinical notes were unavailable in 9 patients. Fifty-three patients (88 %) were male, the mean age was 28 years (range 18 to 50) and 16 subjects (27 %) had suffered a primary dislocation. The overall sensitivity and specificity of MRA to all associated injuries was 0.9 (CI 0.83-0.95) and 0.94 (CI 0.9-0.96) retrospectively. The lowest sensitivity was seen in osseous Bankart 0.8 (CI 0.44-0.96) and superior labral tear (SLAP) lesions 0.5 (CI 0.14-0.86). The overall positive predictive value was 0.88 (CI 0.76-0.91) with the lowest values found in rotator cuff 0.4 (CI 0.07-0.83) and glenohumeral ligament (GHL) lesions 0.29 (CI 0.05-0.7).

CONCLUSION

Magnetic resonance angiography has a high sensitivity when used to identify associated injuries in shoulder dislocation, although in 8 patients (13 %) arthroscopy identified an additional injury. The overall agreement between MRA and arthroscopic findings was good, but the identification of GHL and rotator cuff injuries was poor.

Item Type: Article
Additional Information: This article is accessible to all HEFT staff and students via NICE journals and databases http://www.nice.org.uk/about/what-we-do/evidence-services/journals-and-databases by using their HEFT Athens login IDs
Subjects: WE Musculoskeletal. Orthopaedics
WN Medical imaging. Radiology
Divisions: Planned IP Care > Trauma and Orthopaedics
Related URLs:
Depositing User: Mrs Caroline Tranter
Date Deposited: 31 May 2015 07:24
Last Modified: 31 May 2015 07:24
URI: http://www.repository.heartofengland.nhs.uk/id/eprint/944

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