CT compared with arthroscopy in quantifying glenoid bone loss.
OBJECTIVE
This study investigated the accuracy of CT in determining the presence and severity of glenoid bone loss in patients with unilateral anterior shoulder dislocation.


METHODS
Fifty patients (45 males, five females; mean age, 28.7 years; age range, 14-56 years) with anterior shoulder dislocation underwent shoulder CT examination before arthroscopy (mean time interval between CT and arthroscopy, 28.5 days; range, 9-73 days). Thirteen (26%) of the 50 patients had a single dislocation, whereas the remaining 37 patients (74%) had recurrent dislocation (mean, 8.2 dislocations; range, 2-50 dislocations).


RESULTS
Glenoid bone loss was evident in 41 (82%) of the 50 patients at arthroscopy. Compared with arthroscopy, CT had a sensitivity in detecting glenoid bone loss of 92.7%; specificity, 77.8%; positive predictive value, 95.0%; and negative predictive value, 70.0%. Three false-negative CT assessments had 5%, 10%, and 10% glenoid bone loss, respectively, at arthroscopy. Two false-positive CT assessments had 8.7% and 5.7% glenoid bone loss on CT, although no bone loss was apparent at arthroscopy. There was a strong correlation between CT and arthroscopy with respect to the severity of glenoid bone loss (r = 0.79, 95% CI = 0.659-0.877, p < 0.0001).


CONCLUSIONS
CT has both a high sensitivity and a high specificity for detecting glenoid bone loss, and agreement with arthroscopy regarding the severity of glenoid bone loss is good. CT can be used to assess glenoid bone loss and the need for bone augmentation surgery.
Griffith
James F
JF
Department of Diagnostic Radiology and Organ Imaging, The Chinese University of Hong Kong, Prince of Wales Hospital, 30-32 Ngan Shing St., Shatin, Hong Kong SAR, China.
Yung
Patrick S H
PS
Antonio
Gregory E
GE
Tsang
Polly H
PH
Ahuja
Anil T
AT
Chan
Kai Ming
KM
D000293:Adolescent; D000328:Adult; D001175:Arthrography; D001182:Arthroscopy; D001862:Bone Resorption / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D012783:Shoulder Dislocation / Q000000981:diagnostic imaging*; D012785:Shoulder Joint / Q000000981:diagnostic imaging*; D014057:Tomography, X-Ray Computed