1
|
Lee MH, Park HJ, Kim JN. [Postoperative Imaging of Rotator Cuff Tear]. TAEHAN YONGSANG UIHAKHOE CHI 2021; 82:1388-1401. [PMID: 36238871 PMCID: PMC9431978 DOI: 10.3348/jksr.2021.0132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 10/06/2021] [Accepted: 11/25/2021] [Indexed: 11/15/2022]
Abstract
Postoperative imaging of the rotator cuff may be performed routinely, even if pain or disability develops after surgery or if there are no symptoms. Postoperative images are obtained through MRI or US, and the purpose is to confirm the integrity of the restored tendon in general. Postoperative MRI has a relatively poor diagnostic accuracy compared to that of preoperative images because various materials used in surgeries deteriorate the image quality. US can dynamically check the condition of the restored tendon and avoid artifacts from the surgical instruments used for recovery. Although imaging findings are not always consistent with the clinical symptoms or prognosis, sub-deltoid fluid retention is more important for pain and functional recovery than the thickness of the reconstructed tendon. Strain elastography can also be a useful method for predicting the prognosis.
Collapse
|
2
|
Pagán-Conesa A, García-Ortiz MT, Salmerón-Martínez EJ, Moya-Martínez A, López-Prats F. Diagnostic Ultrasound Shows Reversal of Supraspinatus Muscle Atrophy Following Arthroscopic Rotator Cuff Repair. Arthroscopy 2021; 37:3039-3048. [PMID: 33940124 DOI: 10.1016/j.arthro.2021.04.039] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Revised: 04/11/2021] [Accepted: 04/15/2021] [Indexed: 02/02/2023]
Abstract
PURPOSE Prospective study to assess ultrasonography (US) utility as an imaging tool for supraspinatus muscle atrophy diagnosis, establishing if there is any relationship between repairing supraspinatus tears and its eventual muscular recovery. METHODS Observational study. SELECTION CRITERIA adults with a full-thickness reparable supraspinatus tear confirmed arthroscopically. Clinical and imaging data pre- and postoperatively with 12 months of follow-up were recorded, including demographic data, Constant scale, Patte classification, repair type, and supraspinatus muscle belly US images in both shoulders, recording height, diameter, echogenicity (mean number of pixels between 0-black and 255-white), and central tendon pennate angle (PA). RESULTS In total, 110 supraspinatus tears underwent arthroscopic repair (2015-2018). Mean age was 61 ± 8 years (46-77). We detected a correlation between atrophy and age in terms of echogenicity and PA (P = .01). Echogenicity improved from 54.5 to 51.0 (P = .365) and slightly deteriorated on the contralateral side from 51.6 to 52.9 (P = .351). Supraspinatus echogenicity compared to trapezius muscle reduced from 0.43 to 0.36 (P < .001). PA augmented from 5.8 to 8.6 (P < .001). Mean PA on the contralateral side was 8.6 preoperatively. Patte II cases showed the most significant improvement in terms of imaging evaluation of atrophy. Although Patte III cases almost did not improve in terms of atrophy, they improved clinically. We observed improvement after surgery in Constant score from 35 to 85 (P < .001). Minimal clinically important differences for Constant and visual analog scale were 44.45 ± 12.87 and 6.54 ± 1.41, respectively. Recurrence of symptoms was 13%, related to worse results of PA and echogenicity compared to nonrecurrences. CONCLUSIONS Supraspinatus atrophic muscle changes after repair can be reversed. It can be quantified using US imaging (histogram, histogram ratio and echogenicity reduction, pennate pattern, and PA augmentation). Patte II cases showed the best results after repair, demonstrated by US. The faster the repair, the better the results without being influenced by repair type. The bigger the tear and retraction, the more echogenicity and less PA, with worse clinical and US results. LEVEL OF EVIDENCE Level III, prospective therapeutic study.
Collapse
Affiliation(s)
- Alejandro Pagán-Conesa
- Department of Orthopaedics and Trauma, Elche University General Hospital, Elche, Alicante, Spain.
| | | | | | | | - Fernando López-Prats
- Department of Orthopaedics and Trauma, Elche University General Hospital, Elche, Alicante, Spain; Department of Orthopaedics and Trauma, Miguel-Hernández University, San Juan de Alicante, Spain
| |
Collapse
|
3
|
Tang CT, Decker G, Steger-May K, Middleton W, Teefey S. Method Comparison for Detection and Measurement of Rotator Cuff Tears: Office-based Bedside Ultrasonography by a Single Physiatrist versus Imaging Center-based Ultrasonography by Two Expert Musculoskeletal Radiologists. PM R 2019; 12:563-572. [PMID: 31583842 DOI: 10.1002/pmrj.12256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2019] [Accepted: 09/16/2019] [Indexed: 11/09/2022]
Abstract
INTRODUCTION There is increasing interest among physiatrists in using bedside ultrasonography to assess rotator cuff tears. OBJECTIVE To conduct a method comparison between ultrasonography performed by a single physiatrist at bedside and two validated expert musculoskeletal radiologists at an imaging center. DESIGN Prospective, blinded comparison study. SETTING Academic outpatient clinic and imaging center. PATIENTS Seventy-two unilateral shoulders were scanned. Inclusion criteria included pain or weakness with rotator cuff testing and compliance with repeat ultrasonography. INTERVENTIONS Ultrasonography performed by the physiatrist was done at bedside during the patient's clinical visit, while the radiologists' scan was performed afterwards in an imaging center. The radiologists trained the physiatrist who was performing the scans. MAIN OUTCOME MEASUREMENTS The primary outcome was integrity of the rotator cuff (intact, partial tear, full tear). When a posterior cuff (supraspinatus, infraspinatus, teres minor) tear was detected, measurements of length, width, and distance from the biceps tendon were taken. RESULTS With use of the radiologists' scan as a criterion standard, bedside ultrasonography performed by the physiatrist for detection of posterior cuff tears had a percent perfect agreement of 72.2% for categorization as no tear, partial tear, or full tear. When evaluating dichotomously for presence of a full tear, sensitivity was 82.1% and specificity was 93.9%. Seven (18%) full-thickness tears were missed, and all were essentially small (<15 mm). When physiatrist and radiologist measurements were compared, the mean ± standard deviation (SD) difference in length was 3.4 ± 4.7 mm, width was 2.7 ± 6.7 mm, and distance to the biceps tendon was -0.8 ± 7.5 mm. CONCLUSIONS Office-based bedside ultrasonography is a reasonable modality to rule out medium/large full-thickness posterior cuff tears. However, physicians should be aware that a percentage of small full-thickness tears can be missed. Further imaging should be considered in suspected partial tears and full tears that may be appropriate for surgical repair.
Collapse
Affiliation(s)
- Chi-Tsai Tang
- Division of Physical Medicine and Rehabilitation, Department of Orthopaedic Surgery, Washington University School of Medicine, St. Louis, MO
| | - Gregory Decker
- Division of Physical Medicine and Rehabilitation, Department of Orthopaedic Surgery, Washington University School of Medicine, St. Louis, MO
| | - Karen Steger-May
- Division of Biostatistics, Washington University School of Medicine, St. Louis, MO
| | - William Middleton
- Division of Diagnostic Radiology, Department of Radiology, Washington University School of Medicine, St. Louis, MO
| | - Sharlene Teefey
- Division of Diagnostic Radiology, Department of Radiology, Washington University School of Medicine, St. Louis, MO
| |
Collapse
|
4
|
Kuo YC, Hsieh LF. Validity of Cyriax’s Functional Examination for Diagnosing Shoulder Pain: A Diagnostic Accuracy Study. J Manipulative Physiol Ther 2019; 42:407-415. [DOI: 10.1016/j.jmpt.2018.11.024] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Revised: 11/19/2018] [Accepted: 11/27/2018] [Indexed: 11/25/2022]
|
5
|
Michelin P, Legrand J, Lee KS, Leleup G, Etancelin M, Banse C, Dacher JN, Duparc F. Axillary Sonography of the Shoulder: An Adjunctive Approach. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2018; 37:2707-2715. [PMID: 29575005 DOI: 10.1002/jum.14601] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/12/2017] [Revised: 01/03/2018] [Accepted: 01/06/2018] [Indexed: 06/08/2023]
Abstract
Sonography of the shoulder is widely used to assess various disorders, including tendinous diseases of the rotator cuff and the long head of the biceps brachii muscle. The shoulder is commonly explored through anterior, superior, and posterior approaches, but the inferior axillary approach is rarely considered in the literature. However, this technique allows the direct visualization of relevant anatomic structures. The aim of this pictorial essay is, first, to technically describe this approach and the normal musculoskeletal sonographic anatomy of the region and, second, to present the sonographic findings of shoulder disorders that may be helpfully explored this technique.
Collapse
Affiliation(s)
- Paul Michelin
- Department of Radiology, Rouen University Hospital, Rouen, France
- Laboratory of Anatomy, Faculty of Medicine and Pharmacy of Rouen, University of Normandie, Rouen, France
- CETAPS Laboratory, Faculty of Sports Science of Rouen, University of Normandie, Rouen, France
| | - Julie Legrand
- Department of Radiology, Rouen University Hospital, Rouen, France
| | - Kenneth S Lee
- Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
| | - Grégoire Leleup
- Department of Radiology, Rouen University Hospital, Rouen, France
| | | | - Christopher Banse
- Department of Rheumatology, Rouen University Hospital, Rouen, France
| | | | - Fabrice Duparc
- Department of Orthopedic Surgery and Traumatology, Rouen University Hospital, Rouen, France
- Laboratory of Anatomy, Faculty of Medicine and Pharmacy of Rouen, University of Normandie, Rouen, France
- CETAPS Laboratory, Faculty of Sports Science of Rouen, University of Normandie, Rouen, France
| |
Collapse
|
6
|
McDougall RA, Canapp SO, Canapp DA. Ultrasonographic Findings in 41 Dogs Treated with Bone Marrow Aspirate Concentrate and Platelet-Rich Plasma for a Supraspinatus Tendinopathy: A Retrospective Study. Front Vet Sci 2018; 5:98. [PMID: 29868619 PMCID: PMC5967230 DOI: 10.3389/fvets.2018.00098] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2017] [Accepted: 04/20/2018] [Indexed: 01/20/2023] Open
Abstract
Objective To report sonographic findings for dogs with a supraspinatus tendinopathy (ST) treated with an ultrasound-guided intratendinous injection of bone marrow aspirate concentrate (BMAC) and platelet-rich plasma (PRP). Methods Medical records for dogs diagnosed with an ST and treated with a BMAC-PRP injection were reviewed. Data collected included patient signalment, radiographic findings at the time of initial evaluation, and sonographic findings, including cross-sectional area (CSA), fiber pattern, and echogenicity. Results Of 70 records reviewed, 41 met the inclusion criteria. Mean CSA of the supraspinatus tendon decreased by 0.06 cm2 between baseline and 45 days post-treatment (p = 0.0025), and 0.09 cm2 between baseline and 90 days post-treatment (p < 0.0001). Analysis of CSA in dogs with a unilateral ST at baseline revealed a difference of 0.08 cm2 between the affected and unaffected tendon at baseline, with the affected tendon measuring larger than the contralateral tendon (p < 0.0001). This difference became statistically insignificant by 45 days after treatment (u1-u0 = 0.04 cm2, p = 0.2855) and remained so 90 days post-treatment (u1-u0 = 0.03 cm2, p = 0.1910). In most cases (90.6%), the fiber pattern and echogenicity was considered improved 90 days post treatment. In a minority of these cases (13.8%) the fiber pattern and echogenicity abnormalities were considered resolved. Conclusions Using qualitative and quantitative sonographic measures, BMAC-PRP was associated with an improvement in supraspinatus tendon size, fiber pattern, and echogenicity. Given the protracted nature of tendon healing, long-term evaluation may reveal continued improvements in chronic structural changes not captured during the current study. Functional studies are required to evaluate the clinical benefits of BMAC-PRP in the treatment of STs in dogs. Clinical significance An ST is a common contributor to forelimb lameness in dogs and remains notoriously difficult to treat. Previous studies have been associated with inconsistent treatment outcomes. In the current study, BMAC-PRP is investigated as a minimally invasive treatment option, revealing positive sonographic results.
Collapse
Affiliation(s)
- Renee A McDougall
- Veterinary Orthopedic and Sports Medicine Group, Annapolis Junction, MD, United States
| | - Sherman O Canapp
- Veterinary Orthopedic and Sports Medicine Group, Annapolis Junction, MD, United States
| | - Debra A Canapp
- Veterinary Orthopedic and Sports Medicine Group, Annapolis Junction, MD, United States
| |
Collapse
|
7
|
Comparison of two interventional techniques for the treatment of chronic shoulder pain. COLOMBIAN JOURNAL OF ANESTHESIOLOGY 2018. [DOI: 10.1097/cj9.0000000000000005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
|
8
|
Lee MH, Sheehan SE, Orwin JF, Lee KS. Comprehensive Shoulder US Examination: A Standardized Approach with Multimodality Correlation for Common Shoulder Disease. Radiographics 2017; 36:1606-1627. [PMID: 27726738 DOI: 10.1148/rg.2016160030] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Shoulder pain is one of the most common musculoskeletal conditions encountered in primary care and specialty orthopedic clinic settings. Although magnetic resonance (MR) imaging is typically the modality of choice for evaluating the soft-tissue structures of the shoulder, ultrasonography (US) is becoming an important complementary imaging tool in the evaluation of superficial soft-tissue structures such as the rotator cuff, subacromial-subdeltoid bursa, and biceps tendon. The advantages of US driving its recent increased use include low cost, accessibility, and capability for real-time high-resolution imaging that enables dynamic assessment and needle guidance. As more radiologists are considering incorporating shoulder US into their practices, the development of a standardized approach to performing shoulder US should be a priority to facilitate the delivery of high-quality patient care. Familiarity with and comfort in performing a standardized shoulder US examination, as well as knowledge of the types of anomalies that can be evaluated well with US, will enhance the expertise of those working in musculoskeletal radiology practices and add value in the form of increased patient and health care provider satisfaction. This review describes the utility and benefits of shoulder US as a tool that complements MR imaging in the assessment of shoulder pain. A standardized approach to the shoulder US examination is also described, with a review of the basic technique of this examination, normal anatomy of the shoulder, common indications for shoulder US, and characteristic US findings of common shoulder diseases-with select MR imaging and arthroscopic correlation. Online supplemental material is available for this article. ©RSNA, 2016.
Collapse
Affiliation(s)
- Matthew H Lee
- From the Departments of Radiology (M.H.L., S.E.S., K.S.L.) and Orthopedics and Rehabilitation (J.F.O.), University of Wisconsin School of Medicine and Public Health, Madison, WI
| | - Scott E Sheehan
- From the Departments of Radiology (M.H.L., S.E.S., K.S.L.) and Orthopedics and Rehabilitation (J.F.O.), University of Wisconsin School of Medicine and Public Health, Madison, WI
| | - John F Orwin
- From the Departments of Radiology (M.H.L., S.E.S., K.S.L.) and Orthopedics and Rehabilitation (J.F.O.), University of Wisconsin School of Medicine and Public Health, Madison, WI
| | - Kenneth S Lee
- From the Departments of Radiology (M.H.L., S.E.S., K.S.L.) and Orthopedics and Rehabilitation (J.F.O.), University of Wisconsin School of Medicine and Public Health, Madison, WI
| |
Collapse
|
9
|
Idowu BM, Ayoola OO, Adetiloye VA, Komolafe MA. Sonographic Evaluation of Structural Changes in Post-Stroke Hemiplegic Shoulders. Pol J Radiol 2017; 82:141-148. [PMID: 28382186 PMCID: PMC5360429 DOI: 10.12659/pjr.899684] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2016] [Accepted: 07/08/2016] [Indexed: 12/15/2022] Open
Abstract
Background Stroke and hemiplegia are frequent complications of stroke. This study was performed to sonographically evaluate post-stroke hemiplegic shoulders and explore possible relationship(s) between the sonographic findings and clinical indices. Material/Methods Forty-five stroke patients and 45 age- and sex-matched controls were recruited. Standard sonographic examination of both shoulders was performed to assess for joint subluxation, rotator cuff tears, tendinosis, subacromial-subdeltoid bursitis or effusion and adhesive capsulitis. Results Hemiplegic shoulders exhibited significantly higher number of pathologies compared to the unaffected shoulders and shoulders of controls (p=0.000). One or more structural abnormalities were found in all 45 (100%) hemiplegic shoulders, 25 (55.6%) unaffected shoulders of the stroke subjects, and 39 (43.3%) control shoulders. The most frequent pathologies in the hemiplegic shoulders were the following: tendinosis of the long head of bicep tendon (48.9%), inferior shoulder subluxation (44.4%), co-existing subacromial-subdeltoid bursa/long head of bicep tendon sheath effusion (44.4%), and long head of bicep tendon sheath effusion only (40%). Tendinosis of the long head of bicep tendon was commoner in hemiplegic shoulders with poor motor status than those with good motor status. Conclusions Hemiplegic shoulders have significantly higher number of structural abnormalities than unaffected shoulders and the shoulders of controls. Hemiplegic stroke patients should undergo ultrasonography of the hemiplegic shoulder to define the nature and extent of soft tissue injuries prior to physical therapy.
Collapse
Affiliation(s)
- Bukunmi Michael Idowu
- Department of Radiology, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Osun, Nigeria
| | | | - Victor Adebayo Adetiloye
- Department of Radiology, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Osun, Nigeria
| | | |
Collapse
|
10
|
Okoroha KR, Mehran N, Duncan J, Washington T, Spiering T, Bey MJ, Van Holsbeeck M, Moutzouros V. Characterization of Rotator Cuff Tears: Ultrasound Versus Magnetic Resonance Imaging. Orthopedics 2017; 40:e124-e130. [PMID: 27755645 DOI: 10.3928/01477447-20161013-04] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2016] [Accepted: 08/30/2016] [Indexed: 02/03/2023]
Abstract
Ultrasound and magnetic resonance imaging (MRI) are both capable of diagnosing full-thickness rotator cuff tears. However, it is unknown which imaging modality is more accurate and precise in evaluating the characteristics of full-thickness rotator cuff tears in a surgical population. This study reviewed 114 patients who underwent arthroscopic repair of a full-thickness rotator cuff tear over a 1-year period. Of these patients, 61 had both preoperative MRI and ultrasound for review. Three musculoskeletal radiologists evaluated each ultrasound and MRI in a randomized and blinded fashion on 2 separate occasions. Tear size, retraction status, muscle atrophy, and fatty infiltration were analyzed and compared between the 2 modalities. Ultrasound measurements were statistically smaller in both tear size (P=.001) and retraction status (P=.001) compared with MRI. The 2 image modalities showed comparable intraobserver reliability in assessment of tear size and retraction status. However, MRI showed greater interobserver reliability in assessment of tear size, retraction status, and atrophy. Independent observers are more likely to agree on measurements of the characteristics of rotator cuff tears when using MRI compared with ultrasound. As tear size increases, the 2 image modalities show greater differences in measurement of tear size and retraction status. Additionally, compared with MRI, ultrasound shows consistently low reliability in detecting subtle, but clinically important, degeneration of the soft tissue envelope. Although it is inexpensive and convenient, ultrasound may be best used to identify a tear, and MRI is superior for use in surgical planning for larger tears. [Orthopedics. 2017; 40(1):e124-e130.].
Collapse
|
11
|
Reducing Unnecessary Shoulder MRI Examinations Within a Capitated Health Care System: A Potential Role for Shoulder Ultrasound. J Am Coll Radiol 2016; 13:780-7. [PMID: 27162045 DOI: 10.1016/j.jacr.2016.03.015] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2016] [Revised: 03/01/2016] [Accepted: 03/11/2016] [Indexed: 02/07/2023]
|
12
|
Collin P, Yoshida M, Delarue A, Lucas C, Jossaume T, Lädermann A. Evaluating postoperative rotator cuff healing: Prospective comparison of MRI and ultrasound. Orthop Traumatol Surg Res 2015; 101:S265-8. [PMID: 26283053 DOI: 10.1016/j.otsr.2015.06.006] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2015] [Accepted: 06/16/2015] [Indexed: 02/02/2023]
Abstract
BACKGROUND The objective of this prospective comparative single centre study was to compare postoperative rotator cuff healing rates as assessed by magnetic resonance imaging (MRI) versus ultrasonography (US). MATERIAL AND METHODS Between October 2012 and February 2013, 61 patients underwent arthroscopic repair of postero-superior rotator cuff tears. Each patient underwent MRI and US 6 months later. The findings were assessed independently by two observers. We compared intra-observer and inter-observer levels of agreement regarding healing rates assessed by MRI and US. RESULTS Intra-observer agreement regarding the MRI interpretation was 95% (κ coefficient, 0.83) for one observer and 98% (κ coefficient, 0.94) for the other. Values of κ for inter-observer agreement ranged across readings from 0.76 to 0.90. When MRI was taken as the reference, US had 80% sensitivity and 98% specificity. DISCUSSION MRI and US provide similar assessments of postoperative rotator cuff healing, although US is less sensitive. Intra-observer and inter-observer agreements are very good.
Collapse
Affiliation(s)
- P Collin
- Centre Hospitalier Privé Saint-Grégoire, boulevard Boutière 6, 35768 Saint-Grégoire cedex, France.
| | - M Yoshida
- Centre Hospitalier Privé Saint-Grégoire, boulevard Boutière 6, 35768 Saint-Grégoire cedex, France; Nagoya City University Graduate School of Medical Science, Nagoya, Japan
| | - A Delarue
- Service de kinésithérapie, Unité de Réadaptation Fonctionnelle en Milieu Professionnel Le Patis Fraux, 35770 Vern-sur-Seiche, France
| | - C Lucas
- Centre Hospitalier Privé Saint-Grégoire, boulevard Boutière 6, 35768 Saint-Grégoire cedex, France
| | - T Jossaume
- Centre Hospitalier Privé Saint-Grégoire, boulevard Boutière 6, 35768 Saint-Grégoire cedex, France
| | - A Lädermann
- Service de chirurgie orthopédique et traumatologie de l'appareil moteur, Hôpitaux Universitaires de Genève, rue Gabrielle-Perret-Gentil 4, 1211 Geneva 14, Switzerland; Faculté de médecine, Université de Genève, rue Michel-Servet 1, 1211 Geneva 4, Switzerland; Service de chirurgie orthopédique et traumatologie de l'appareil moteur, Hôpital de La Tour, rue J.-D.-Maillard 3, 1217 Meyrin, Switzerland
| | | |
Collapse
|
13
|
Moon SH, Ko KP, Baek SI, Lee S. Ultrasonography and Ultrasound-guided Interventions of the Shoulder. Clin Shoulder Elb 2015. [DOI: 10.5397/cise.2015.18.3.172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
|
14
|
The relationship between subacromial bursa thickness on ultrasound and shoulder pain in open water endurance swimmers over time. J Sci Med Sport 2015; 18:373-7. [DOI: 10.1016/j.jsams.2014.05.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2013] [Revised: 04/21/2014] [Accepted: 05/11/2014] [Indexed: 11/19/2022]
|
15
|
Do subacromial ultrasonography findings predict efficacy of intra-bursal injection? Prospective study in 39 patients. Orthop Traumatol Surg Res 2014; 100:S361-4. [PMID: 25454329 DOI: 10.1016/j.otsr.2014.09.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2014] [Accepted: 09/17/2014] [Indexed: 02/02/2023]
Abstract
BACKGROUND Ultrasonography has become an investigation of choice in the management of shoulder pain. The objective of this study was to determine whether the efficacy of subacromial-subdeltoid bursa injection correlated with the ultrasound findings. MATERIAL AND METHODS We prospectively recruited patients who were seen between November 2012 and November 2013 for subacromial pain and whose rotator cuff was either intact or showed a full-thickness tear less than 1cm in length. A standardised physical examination of the shoulder was followed immediately by static and dynamic ultrasonography, intra-bursal injection of lidocaine, and a repetition of the same physical examination. Recorded ultrasonography features were the appearance of the bursa, shape of the coraco-acromial ligament, and bursal deformation induced by passage under the coraco-acromial ligament during dynamic imaging. A response to the injection was defined as greater than 75% improvements in at least three of the physical examination parameters. RESULTS We included 39 patients with a mean age of 56.7 years. Ultrasonography showed abnormalities of the bursa in 30 patients, including 1 with an intra-bursal effusion, 10 with thickening, and 19 with both. Deformation of the bursa under the coraco-acromial ligament was noted in 26 patients. The proportions of patients with bursal effusion and with bursal thickening were similar in the 20 responders and 19 non-responders. Neither were any significant differences found for coraco-acromial ligament shape or bursal deformation under the ligament. CONCLUSIONS No correlation was found between ultrasonography findings and the efficacy of a local anaesthetic injection into the subacromial bursa. These findings suggest that ultrasound abnormalities may constitute mere physiological changes, in keeping with earlier studies in asymptomatic individuals. Thus, subacromial impingement may be currently overdiagnosed.
Collapse
|
16
|
Codsi MJ, Rodeo SA, Scalise JJ, Moorehead TM, Ma CB. Assessment of rotator cuff repair integrity using ultrasound and magnetic resonance imaging in a multicenter study. J Shoulder Elbow Surg 2014; 23:1468-72. [PMID: 24751529 DOI: 10.1016/j.jse.2014.01.045] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2013] [Revised: 01/23/2014] [Accepted: 01/27/2014] [Indexed: 02/01/2023]
Abstract
BACKGROUND This study compared ultrasound and magnetic resonance imaging (MRI) evaluation of the repaired rotator cuff to determine concordance between these imaging studies. METHODS We performed a concordance study using the data from a prospective nonrandomized multicenter study at 13 centers. A suture bridge technique was used to repair 113 rotator cuff tears that were between 1 and 4 cm wide. Repairs were evaluated with MRI and ultrasound at multiple time points after surgery. The MRI scans were read by a central radiologist and the surgeon, and the ultrasounds were read by a local radiologist or the surgeon who performed the ultrasound. RESULTS The concordance between the central radiologist's MRI reading and the investigator's MRI readings at all time points was 89%, with a κ coefficient of 0.60. The concordance between the central radiologist's MRI and ultrasound readings at all time points was 85%, with a κ coefficient of 0.40. The concordance between the investigator's MRI and ultrasound readings was 92%, with a κ coefficient of 0.70. CONCLUSIONS In the community setting, ultrasound may be used to evaluate the integrity of a repaired rotator cuff tendon and constitutes a comparable alternative to MRI when evaluating the integrity of a rotator cuff repair. Clinical investigators should compare their postoperative ultrasound results with their postoperative MRI results for a certain time period to establish the accuracy of ultrasound before relying solely on ultrasound imaging to evaluate the integrity of their rotator cuff repairs.
Collapse
Affiliation(s)
| | | | | | | | - C Benjamin Ma
- University of California San Francisco, Orthopedic Surgery, San Francisco, CA, USA
| |
Collapse
|