Correlation between MRI and Arthroscopy in Diagnosis of Shoulder Pathology
Introduction: Shoulder pain can cause significant pain, discomfort and reduce the ability to perform activities of daily living, thus making it the third most common cause of musculoskeletal consultation. The current gold standard diagnostic investigation is arthroscopy. MRI is a proved sensiti...
| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
| Published: |
JCDR Research and Publications Private Limited
2016-02-01
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| Series: | Journal of Clinical and Diagnostic Research |
| Subjects: | |
| Online Access: | https://jcdr.net/articles/PDF/7309/14867_CE(RA1)_F(GH)_PF1(BMAK)_PFA(AK)_PF2(PAG).pdf |
| Summary: | Introduction: Shoulder pain can cause significant pain,
discomfort and reduce the ability to perform activities of
daily living, thus making it the third most common cause
of musculoskeletal consultation. The current gold standard
diagnostic investigation is arthroscopy. MRI is a proved
sensitive and accurate non-invasive tool in investigating
shoulder pathology, but false and misleading results are equally
reported.
Aim: The aim of the study is to compare the efficacy of MRI in
diagnosing shoulder pathologies in comparison to arthroscopy,
considering arthroscopy as the gold standard.
Materials and Methods: Thirty nine consecutive patients,
between 18-80 years of age, presenting with chronic shoulder
pain or instability of more than 6 weeks, or with clinical signs
of impingement or tear were included in the study. MRI of the
shoulder joint was done followed by shoulder arthroscopy.
The data collected was analysed for the significant correlation
between MRI of shoulder and arthroscopic findings by kappa
statistics.
Results: Out of 39 patients, Rotator cuff (RC) tear was the most
common pathology. MRI showed excellent sensitivity in the
diagnosis of rotator cuff tears (0.91) and osteochondral defects
(OCD), very good sensitivity for Bankart's lesion (0.8) and had
poor sensitivity to detect SLAP tear (0.15). MRI was specific
for all shoulder pathologies. MRI detected RC tears with kappa
score of 0.73, Bankart's tear and OCD's with kappa score of
0.83 and 1.0 respectively and SLAP lesion with kappa score of
0.14. The accuracy of MRI was highest in diagnosing OCD's
(1.0), followed by RC tear (0.9), Bankart's tear (0.9) and accuracy
was least in diagnosing SLAP lesion (0.7). False negative results
were more than false positives.
Conclusion: The present study supports that MRI is effective in
diagnosing rotator cuff tears, Bankart's tear and ostechondral
defects but was not found to be helpful in diagnosing SLAP
lesions. MRI and arthroscopy have complimentary roles in the
diagnosis of shoulder pathology. |
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| ISSN: | 2249-782X 0973-709X |