High-resolution ultrasound in the diagnosis of upper limb disorders: a tertiary referral centre experience.
The purpose of this study is to determine the reliability of high-resolution ultrasound (HRUS) in the diagnosis of upper limb disorders compared with the initial clinical opinion. We prospectively studied 178 patients referred for HRUS examination (47.2% hand, 34.8% wrist, and 18% elbow examinations) by recording the clinical opinion, the specific ultrasound diagnosis, and the final diagnosis, as established by surgery (79.9%) or follow-up (20.1%). HRUS examination was highly reliable in diagnosing cystic lesions, synovial disease, ligament injury and foreign bodies (100%), and slightly less reliable for solid lesions (82.1%) and nerve, bone, and tendon disorders (97%, 91.7%, 86.5%, respectively). HRUS examination resulted in significantly more correct diagnoses (92.1%) than the clinical opinion (70.8%) (McNemar test, P = 0.001). The agreement between the HRUS diagnosis and the clinical opinion was slight (Kappa test, k = 0.16). HRUS examination is more reliable than clinical examination in diagnosing upper limb disorders.
Allen
Gina M
GM
Department of Radiology, Selly Oak and Royal Orthopaedic Hospitals, Birmingham, UK.
Drakonaki
Eleni E
EE
Tan
Melissa Ley H
ML
Dhillon
Manpreet
M
Rajaratnam
Vaikunthan
V
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001847:Bone Diseases / Q000175:diagnosis / Q000000981:diagnostic imaging; D003937:Diagnosis, Differential; D005260:Female; D005547:Foreign Bodies / Q000175:diagnosis / Q000000981:diagnostic imaging*; D006801:Humans; D008022:Ligaments / Q000000981:diagnostic imaging* / Q000293:injuries; D008297:Male; D008487:Medical History Taking; D008875:Middle Aged; D009468:Neuromuscular Diseases / Q000175:diagnosis / Q000000981:diagnostic imaging*; D010523:Peripheral Nervous System Diseases / Q000175:diagnosis / Q000000981:diagnostic imaging; D010808:Physical Examination; D011446:Prospective Studies; D015203:Reproducibility of Results; D013581:Synovial Cyst / Q000000981:diagnostic imaging; D052256:Tendinopathy / Q000175:diagnosis / Q000000981:diagnostic imaging*; D014463:Ultrasonography; D034941:Upper Extremity / Q000000981:diagnostic imaging*