Department of Orthopedics and Traumatology, Ankara Training and Research Hospital, Ankara, Turkey.
Knee Surg Sports Traumatol Arthrosc. 2021 Aug;29(8):2616-2623. doi: 10.1007/s00167-021-06518-7. Epub 2021 Mar 1.
The aim of the present study was to compare the diagnostic values of clinical tests and magnetic resonance imaging (MRI) which used for the diagnosis of subscapularis (SSc) tears in the patients who underwent arthroscopic rotator cuff surgery.
Two-hundred and nine consecutive patients who underwent arthroscopic rotator cuff surgery between 2015 and 2019 were analyzed. The lift-off test, belly-press test and bear-hug test were performed preoperatively. 1.5 T MRI scans of all patients were evaluated for SSc integrity. The diagnostic values of both clinical tests and MRI were calculated. SSc tears were graded according to Fox and Romeo. Arthroscopic findings were used as the gold standard for diagnosis of SSc tears.
There were 54 SSc tears accounting for an prevalence of 29%. The BHT showed the greatest sensitivity for both type II-II-IV (73.3%) and all types of (68.5%) SSc tears. The sensitivity and specificity of the combined test and MRI were 91.1-87.2% and 93.3-90.8% in Type II-III-IV SSc tears, respectively, and 81.5-88.6% and 88.9-94.7% in all SSc tears, respectively. There were no statistically significant difference between combined test and MRI in terms of sensitivity and specificity (n.s.).
The present study is the first that compared both clinical tests and MRI with arthroscopic findings in terms of sensitivity and specificity in the same patient group. A combination of clinical tests increases their diagnostic values and shows similar sensitivity and specificity as MRI.
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本研究旨在比较临床检查和磁共振成像（MRI）在接受关节镜肩袖手术的患者中用于诊断肩胛下肌（SSc）撕裂的诊断价值。
分析了 2015 年至 2019 年间接受关节镜肩袖手术的 209 例连续患者。术前进行了升举试验、腹部按压试验和熊抱试验。对所有患者进行 1.5T MRI 扫描以评估 SSc 完整性。计算了两种临床检查和 MRI 的诊断价值。根据 Fox 和 Romeo 对 SSc 撕裂进行分级。关节镜检查结果被用作 SSc 撕裂诊断的金标准。
有 54 例 SSc 撕裂，占患病率的 29%。BHT 对 II 型-II 型-IV 型（73.3%）和所有类型（68.5%）SSc 撕裂均具有最大的敏感性。联合试验和 MRI 的敏感性和特异性分别为 II-III-IV 型 SSc 撕裂的 91.1-87.2%和 93.3-90.8%，所有 SSc 撕裂的 81.5-88.6%和 88.9-94.7%。在敏感性和特异性方面，联合试验和 MRI 之间没有统计学差异（n.s.）。
本研究是首次在同一患者组中比较了临床检查和 MRI 在敏感性和特异性方面的结果。临床检查的联合使用增加了其诊断价值，并显示出与 MRI 相似的敏感性和特异性。
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