Pre-operative Assessment of Shoulder Pathologies on MRI by a Radiologist and an Orthopaedic Surgeon
https://doi.org/10.5704/MOJ.2403.006
- Author:
Winkler S
1
;
Herbst B
1
;
Kafchitsas K
1
;
Wohlmuth P
2
;
Hoffstetter P
3
;
Rueth MJ
4
Author Information
1. Department of Orthopaedic Surgery, Asklepios Hospital Lindenlohe, Schwandorf, Germany
2. Department of Research, ASKLEPIOS Proresearch, Hamburg, Germany
3. Department of Radiology, University of Regensburg, Regensburg, Germany
4. Department Sports Clinic, Sportklinik Fichtelgebirge, Markredwitz, Germany
- Publication Type:Journal Article
- Keywords:
MRI, biceps tendon, surgeon, shoulder, radiologist
- From:Malaysian Orthopaedic Journal
2024;18(No.1):42-50
- CountryMalaysia
- Language:English
-
Abstract:
Introduction: Pathologies of the shoulder, i.e. rotator cuff
tears and labral injuries are very common. Most patients
receive MRI examination prior to surgery. A correct
assessment of pathologies is significant for a detailed patient
education and planning of surgery.
Materials and methods: Sixty-nine patients were identified,
who underwent both, a standardised shoulder MRI and
following arthroscopic shoulder surgery in our hospital. For
this retrospective comparative study, the MRIs were
pseudonymised and evaluated separately by an orthopaedic
surgeon and a radiologist. A third rater evaluated images and
reports of shoulder surgery, which served as positive control.
Results of all raters were then compared. The aim was an
analysis of agreement rates of diagnostic accuracy of preoperative MRI by a radiologist and an orthopaedic surgeon.
Results: The overall agreement with positive control of
detecting transmural cuff tears was high (84% and 89%) and
lower for partial tears (70-80%). Subscapularis tears were
assessed with moderate rates of agreement (60 – 70%)
compared to intra-operative findings. Labral pathologies
were detected mostly correctly. SLAP lesions and pulley
lesions of the LHB were identified with only moderate
agreement (66.4% and 57.2%) and had a high inter-rater
disagreement.
Conclusion: This study demonstrated that tears of the rotator
cuff (supraspinatus, infraspinatus) and labral pathologies can
be assessed in non-contrast pre-operative shoulder MRI
images with a high accuracy. This allows a detailed planning
of surgery and aftercare. Pathologies of the subscapularis
tendon, SLAP lesions and biceps instabilities are more
challenging to detect correctly. There were only small
differences between a radiologic and orthopaedic
interpretation of the images.
- Full text:202408071233420004016.2024my1350.pdf
