title: Comparison of magnetic resonance arthrography with arthroscopy for imaging of shoulder injuries: retrospective study.
abstract: BACKGROUND Arthroscopy is the established 'gold standard' diagnostic investigation for detection of shoulder disorders. We aimed to compare the diagnostic accuracy of arthroscopy with magnetic resonance arthrography (MRA) for detection of shoulder disorders. METHODS Patients who underwent arthroscopy by a single surgeon and preoperative MRA between February 2011 and March 2012 for shoulder instability were identified. MRAs were reported by experienced musculoskeletal radiologists. Labral tears, anterior labral tears, superior labral anterior posterior (SLAP) lesions, posterior labral tears, rotator-cuff tears (RCTs), osteoarthritis, loose bodies and Hill-Sachs lesions were identified. Sensitivity, specificity, positive predictive value and negative predictive value, positive likelihood ratio and negative likelihood ratio were calculated. RESULTS A total of 194 patients were identified. The sensitivity and specificity for anterior labral tears was 0.60 and 0.92, SLAP lesions was 0.75 and 0.81, posterior labral tears was 0.57 and 0.96, any labral tear was 0.87 and 0.76, Hill-Sachs lesions was 0.91 and 0.91, RCTs was 0.71 and 0.86, osteoarthritis was 0.72 and 0.95, and loose bodies was 0.22 and 0.96, respectively. The positive predictive value and negative predictive value for anterior labral tears were 0.88 and 0.71, SLAP lesions was 0.64 and 0.88, posterior labral tears was 0.74 and 0.45, any labral tear was 0.89 and 0.71, Hill-Sachs lesions was 0.66 and 0.98, RCTs was 0.47 and 0.95, osteoarthritis was 0.70 and 0.95, and loose bodies was 0.27 and 0.95, respectively. CONCLUSIONS MRA has high diagnostic accuracy for labral tears and Hill-Sachs lesions, but whether MRA should be the first-line imaging modality is controversial.
authors.affiliation: Salford Royal Hospital , UK.
authors.forename: R
authors.initials: R
authors.lastname: Saqib
authors.affiliation: Salford Royal Hospital , UK.
authors.forename: J
authors.initials: J
authors.lastname: Harris
authors.affiliation: Wrightington Hospital , UK.
authors.forename: L
authors.initials: L
authors.lastname: Funk
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001175:Arthrography; D001182:Arthroscopy; D005260:Female; D006801:Humans; D007594:Joint Loose Bodies / Q000175:diagnosis / Q000000981:diagnostic imaging*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010003:Osteoarthritis / Q000175:diagnosis / Q000000981:diagnostic imaging*; D012189:Retrospective Studies; D000070636:Rotator Cuff Injuries / Q000175:diagnosis / Q000000981:diagnostic imaging*; D012680:Sensitivity and Specificity; D000070599:Shoulder Injuries / Q000175:diagnosis / Q000000981:diagnostic imaging; D012785:Shoulder Joint / Q000000981:diagnostic imaging* / Q000601:surgery; D055815:Young Adult
keywords: Arthroscopy; Hill; Magnetic resonance arthrography; Rotator cuff; Sachs; Tears