Fatih Yıldız1, Kerem Bilsel2, Anıl Pulatkan2, Gökçer Uzer2, Ayşe Aralaşmak3, Musa Atay3. 1. Department of Orthopaedics and Traumatology, School of Medicine, Bezmialem Vakif University, Vatan Cd, Fatih, 34093, Istanbul, Turkey. yildizfatih@hotmail.com. 2. Department of Orthopaedics and Traumatology, School of Medicine, Bezmialem Vakif University, Vatan Cd, Fatih, 34093, Istanbul, Turkey. 3. Department of Radiology, School of Medicine, Bezmialem Vakif University, Vatan Cd, Fatih, 34093, Istanbul, Turkey.
Abstract
PURPOSE: The physical examination of the shoulder is usually not reliable for the true diagnosis of superior glenoid labrum anterior to posterior (SLAP) lesions. Magnetic resonance imaging (MRI) has been routinely used for the diagnosis. This prospective study investigates the radiological diagnosis of the SLAP lesions and compares accuracy of arthroscopic and MRI classifications. METHODS: One hundred thirty-two patients with positive physical examination signs using O'Brien, Yergason, resistance supination external rotation and Krank tests and MRI findings are included in the study. Shoulder MRIs were obtained for all patients within three months prior to the surgeries. SLAP lesion is detected in 90 and 102 patients according to MRI and arthroscopy, respectively. Arthroscopic and MRI classifications of the patients were performed according to modified Snyder classification. RESULTS: Sensitivity and specificity of the MRI were found as 70.59 and 40%, respectively. No difference was detected between MRI and arthroscopy classifications in 52 (39%) patients. Although the diagnosis was compatible with arthroscopy in 34 (25%) patients, the classification was incompatible. In 46 (34%) of patients the diagnosis was incompatible with the MRI. CONCLUSION: Although MRI is a good diagnostic tool for SLAP lesions, its use for the classification is limited. Level of evidence Level III, Diagnostic study.
PURPOSE: The physical examination of the shoulder is usually not reliable for the true diagnosis of superior glenoid labrum anterior to posterior (SLAP) lesions. Magnetic resonance imaging (MRI) has been routinely used for the diagnosis. This prospective study investigates the radiological diagnosis of the SLAP lesions and compares accuracy of arthroscopic and MRI classifications. METHODS: One hundred thirty-two patients with positive physical examination signs using O'Brien, Yergason, resistance supination external rotation and Krank tests and MRI findings are included in the study. Shoulder MRIs were obtained for all patients within three months prior to the surgeries. SLAP lesion is detected in 90 and 102 patients according to MRI and arthroscopy, respectively. Arthroscopic and MRI classifications of the patients were performed according to modified Snyder classification. RESULTS: Sensitivity and specificity of the MRI were found as 70.59 and 40%, respectively. No difference was detected between MRI and arthroscopy classifications in 52 (39%) patients. Although the diagnosis was compatible with arthroscopy in 34 (25%) patients, the classification was incompatible. In 46 (34%) of patients the diagnosis was incompatible with the MRI. CONCLUSION: Although MRI is a good diagnostic tool for SLAP lesions, its use for the classification is limited. Level of evidence Level III, Diagnostic study.
Authors: Andrea Lazik-Palm; Oliver Kraff; Stefan H G Rietsch; Mark E Ladd; Michael Kamminga; Sascha Beck; Harald H Quick; Jens M Theysohn Journal: Eur Radiol Exp Date: 2020-02-07