Adriani Marco, Saccomanno Maristella Francesca, Bergomi Andrea, De Filippo Francesco, Daffara Valerio, Milano Giuseppe
Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy.
Department of Bone and Joint Surgery, Spedali Civili, Brescia, Italy.
Knee Surg Sports Traumatol Arthrosc. 2025 May;33(5):1844-1852. doi: 10.1002/ksa.12531. Epub 2024 Nov 4.
Recurrent shoulder instability, a common musculoskeletal disorder, often involves glenoid bone loss and Hill-Sachs lesions. However, the optimal imaging modality for accurately and reliably quantifying bipolar bone loss remains uncertain. This systematic review aims to evaluate the accuracy and reliability of various imaging modalities in assessing bipolar bone loss in anterior shoulder instability.
Major electronic databases were searched for English-language studies reporting the measurement of glenoid track width and/or determination of on/off track HSL through imaging. Studies reporting statistical measures such as area under the curve, sensitivity, specificity, positive predictive value, NPV, intraobserver reliability and interobserver reliability were included. Data extraction and risk of bias assessment were performed independently by two reviewers.
The systematic review included 19 studies comprising 1567 shoulders. Overall, studies could be divided into those looking at the accuracy or reliability of determining glenoid track width, on- or off-track Hill-Sachs lesions and near-track lesions. Three-dimensional images of computed tomography (3D-CT) was the most reliable and accurate imaging modality to measure the glenoid track width. On the opposite, two-dimensional magnetic resonance imaging (2D-MRI) did not provide enough evidence of accuracy and reliability in the determination of On/Off track lesions and near-track lesions.
3D-CT demonstrated excellent reliability for measuring glenoid track width. However, the reliability of 2D-MRI for determining on/off track Hill-Sachs lesions is still controversial.
Level III.
复发性肩关节不稳是一种常见的肌肉骨骼疾病，常伴有肩胛盂骨质流失和希尔-萨克斯损伤。然而，用于准确可靠地量化双侧骨质流失的最佳成像方式仍不明确。本系统评价旨在评估各种成像方式在评估前肩关节不稳双侧骨质流失中的准确性和可靠性。
检索主要电子数据库，查找报告通过成像测量肩胛盂轨迹宽度和/或确定希尔-萨克斯损伤是否在轨迹内/外的英文研究。纳入报告曲线下面积、敏感性、特异性、阳性预测值、阴性预测值、观察者内可靠性和观察者间可靠性等统计指标的研究。由两名评价者独立进行数据提取和偏倚风险评估。
该系统评价纳入19项研究，共1567例肩关节。总体而言，研究可分为观察肩胛盂轨迹宽度、轨迹内/外希尔-萨克斯损伤和轨迹附近损伤的准确性或可靠性的研究。计算机断层扫描三维图像（3D-CT）是测量肩胛盂轨迹宽度最可靠、最准确的成像方式。相反，二维磁共振成像（2D-MRI）在确定轨迹内/外损伤和轨迹附近损伤方面，没有提供足够的准确性和可靠性证据。
3D-CT在测量肩胛盂轨迹宽度方面显示出极佳的可靠性。然而，2D-MRI在确定希尔-萨克斯损伤是否在轨迹内/外方面的可靠性仍存在争议。
三级。
