title: Cartilage lesions of the glenohumeral joint: diagnostic effectiveness of multidetector spiral CT arthrography and comparison with arthroscopy.
abstract: This study assessed the diagnostic effectiveness of multidetector spiral CT arthrography (MDCTa) in detecting hyaline cartilage abnormalities of the shoulder joint, with correlation to arthroscopy. Shoulder MDCTa images prospectively obtained in 22 consecutive patients (mean age, 50 years; age range, 23-74 years; 12 female, 10 male) were evaluated for glenohumeral cartilage lesions. Two musculoskeletal radiologists independently analysed the cartilage surfaces of the humeral head and of the glenoid fossa in nine anatomical surface areas. Observations of MDCTa were compared to arthroscopic findings. The sensitivity and specificity of MDCTa for grade 2 (substance loss <50%) or higher and grade 3 (substance loss >or=50%) or higher cartilage lesions, the Spearman correlation coefficient between arthrographic and arthroscopic grading, and K statistics for assessing Intra and Interobserver reproducibility were determined. At MDCTa, sensitivities and specificities ranged between 80% and 94% for the detection of grade 2 or higher cartilage lesions, and between 88% and 98% for the detection of grade 3 or higher cartilage lesions. Spearman correlation coefficients between MDCTa and arthroscopic grading of articular surfaces ranged between 0.532 and 0.651. Interobserver agreement was moderate for grading all articular surfaces (kappa = 0.457), but substantial to almost perfect for detecting lesions with substance loss (kappa, 0.618-0.876). In conclusion, MDCTa is accurate for the study of cartilage surface in the entire shoulder joint. This technique may beneficially impact patient's management by means of selecting the proper treatment approach.
authors.affiliation: Department of Radiology, Cliniques Universitaires St Luc, Université Catholique de Louvain, Brussels, Belgium. lecouvet@rdgn.ucl.ac.be
authors.forename: Frédéric E
authors.initials: FE
authors.lastname: Lecouvet
authors.forename: Benjamin
authors.initials: B
authors.lastname: Dorzée
authors.forename: Jean E
authors.initials: JE
authors.lastname: Dubuc
authors.forename: Bruno C
authors.initials: BC
authors.lastname: Vande Berg
authors.forename: Jacques
authors.initials: J
authors.lastname: Jamart
authors.forename: Jacques
authors.initials: J
authors.lastname: Malghem
mesh_terms: D000328:Adult; D000368:Aged; D001175:Arthrography; D002114:Calcinosis / Q000000981:diagnostic imaging; D002358:Cartilage, Articular / Q000000981:diagnostic imaging*; D002908:Chronic Disease; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D007592:Joint Diseases / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D010003:Osteoarthritis / Q000000981:diagnostic imaging; D018216:Osteochondromatosis / Q000000981:diagnostic imaging; D012008:Recurrence; D012189:Retrospective Studies; D017006:Rotator Cuff / Q000000981:diagnostic imaging; D000070636:Rotator Cuff Injuries; D012783:Shoulder Dislocation / Q000000981:diagnostic imaging; D019534:Shoulder Impingement Syndrome / Q000000981:diagnostic imaging; D012785:Shoulder Joint / Q000000981:diagnostic imaging*; D020069:Shoulder Pain / Q000000981:diagnostic imaging / Q000209:etiology*; D052256:Tendinopathy / Q000000981:diagnostic imaging; D036542:Tomography, Spiral Computed