Marcello Zappia1, Michela Carfora2, Alfonso Maria Romano3, Alfonso Reginelli4, Luca Brunese5, Antonio Rotondo4, Alessandro Castagna6. 1. Dipartimento di Medicina e di Scienze della Salute, Università degli Studi del Molise, Campobasso, Italy. marcellozappia1@tin.it. 2. Diagnostica Amato, San Marcellino, CE, Italy. 3. Campolongo Hospital, Marina di Eboli, SA, Italy. 4. Dipartimento Magrassi-Lanzara, Seconda Università degli Studi di Napoli, Napoli, Italy. 5. Dipartimento di Medicina e di Scienze della Salute, Università degli Studi del Molise, Campobasso, Italy. 6. Humanitas Research Hospital, Rozzano, Milan, Italy.
Abstract
OBJECTIVE: The aim of this study is to determine the diagnostic accuracy of sonography in order to identify the chondral print on the humeral head. MATERIALS AND METHODS: In total, 44 patients who had already been candidates for arthroscopic surgery were prospectively studied with ultrasound to assess the presence of humeral subchondral erosion at the level of the biceps pulley; no patient had undergone previous surgery or radiographic calcification of rotator cuff tendons. Using arthroscopy as the reference standard the sensitivity, specificity, positive predictive, negative predictive and diagnostic accuracy values were calculated. RESULTS: Of the 44 patients, arthroscopy showed the humeral chondral print in 30 patients. Of the 30 arthroscopy proven humeral chondral prints, ultrasound identified 28 subchondral erosions at the same level, with two false negatives. One of the 14 patients without arthroscopic humeral chondral print was positive for subchondral erosion at ultrasound. The sensitivity, specificity, positive predictive, negative predictive, and diagnostic accuracy values of ultrasound were respectively of 93, 93, 96, 87 and 93%. CONCLUSION: Ultrasound has a good diagnostic accuracy in identifying the chondral print sign.
OBJECTIVE: The aim of this study is to determine the diagnostic accuracy of sonography in order to identify the chondral print on the humeral head. MATERIALS AND METHODS: In total, 44 patients who had already been candidates for arthroscopic surgery were prospectively studied with ultrasound to assess the presence of humeral subchondral erosion at the level of the biceps pulley; no patient had undergone previous surgery or radiographic calcification of rotator cuff tendons. Using arthroscopy as the reference standard the sensitivity, specificity, positive predictive, negative predictive and diagnostic accuracy values were calculated. RESULTS: Of the 44 patients, arthroscopy showed the humeral chondral print in 30 patients. Of the 30 arthroscopy proven humeral chondral prints, ultrasound identified 28 subchondral erosions at the same level, with two false negatives. One of the 14 patients without arthroscopic humeral chondral print was positive for subchondral erosion at ultrasound. The sensitivity, specificity, positive predictive, negative predictive, and diagnostic accuracy values of ultrasound were respectively of 93, 93, 96, 87 and 93%. CONCLUSION: Ultrasound has a good diagnostic accuracy in identifying the chondral print sign.
Entities:
Keywords:
Biceps pulley; Hidden lesion; Long head biceps tendon (LHB) instability; Shoulder; Ultrasound
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