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Diagnostic Needle Arthroscopy of the Shoulder: A Validation Study

BACKGROUND: Diagnostic needle arthroscopy offers an alternative imaging modality to magnetic resonance imaging (MRI) for the diagnosis of intra-articular pathology. PURPOSE: To compare the accuracy of a needle arthroscopy device (Mi-eye2) versus MRI in identifying intra-articular anatomic abnormalit...

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Autores principales: Chowdhury, Alex, Gibson, Catherine, Nicholls, Alex, MacLeod, Iain, Colaco, Henry
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10413894/
https://www.ncbi.nlm.nih.gov/pubmed/37576458
http://dx.doi.org/10.1177/23259671231155885
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author Chowdhury, Alex
Gibson, Catherine
Nicholls, Alex
MacLeod, Iain
Colaco, Henry
author_facet Chowdhury, Alex
Gibson, Catherine
Nicholls, Alex
MacLeod, Iain
Colaco, Henry
author_sort Chowdhury, Alex
collection PubMed
description BACKGROUND: Diagnostic needle arthroscopy offers an alternative imaging modality to magnetic resonance imaging (MRI) for the diagnosis of intra-articular pathology. PURPOSE: To compare the accuracy of a needle arthroscopy device (Mi-eye2) versus MRI in identifying intra-articular anatomic abnormalities in the glenohumeral joint, with formal arthroscopy as the gold standard. STUDY DESIGN: Cohort study; Level of evidence, 2. METHODS: A total of 22 patients underwent diagnostic needle arthroscopy of the shoulder, of whom 20 had preoperative MRI scans. A standardized 12-point noninstrumented diagnostic arthroscopy was performed on each patient using the 0° needle arthroscope, followed by a 30°, 4 mm–diameter conventional arthroscope. Intraoperative images were randomized and reviewed by 2 independent blinded fellowship-trained shoulder surgeons for identification of key pathology and anatomic structures. The MRI scans were reviewed by a single musculoskeletal radiologist to identify pathology in the same key areas. RESULTS: For the identification of rotator cuff pathology, needle arthroscopy (sensitivity, 0.75; specificity, 1.00) was superior to MRI (sensitivity, 0.75; specificity, 0.75) with an interobserver reliability (κ) of 0.703. For long head of the biceps pathology, needle arthroscopy (sensitivity, 0.67; specificity, 0.95) was superior to MRI (sensitivity, 0.00; specificity, 0.83). It was less accurate for labral (sensitivity, 0.33; specificity, 0.50; κ = 0.522) and articular cartilage pathology (sensitivity, 0.00; specificity, 0.94; κ = 0.353). The number of anatomic structures that could be clearly identified was 8.35 of 12 (69.58%) for needle arthroscopy versus 10.35 of 12 (86.25%) for standard arthroscopy. CONCLUSION: Diagnostic needle arthroscopy was found to be more accurate than MRI for the diagnosis of rotator cuff and long head of the biceps pathology but was less accurate for diagnosing labral and cartilage pathology. Although the field of view of a 0° needle arthroscope is not equivalent to a 30° conventional arthroscope, it presents an alternative with potential for use in an outpatient setting.
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spelling pubmed-104138942023-08-11 Diagnostic Needle Arthroscopy of the Shoulder: A Validation Study Chowdhury, Alex Gibson, Catherine Nicholls, Alex MacLeod, Iain Colaco, Henry Orthop J Sports Med Article BACKGROUND: Diagnostic needle arthroscopy offers an alternative imaging modality to magnetic resonance imaging (MRI) for the diagnosis of intra-articular pathology. PURPOSE: To compare the accuracy of a needle arthroscopy device (Mi-eye2) versus MRI in identifying intra-articular anatomic abnormalities in the glenohumeral joint, with formal arthroscopy as the gold standard. STUDY DESIGN: Cohort study; Level of evidence, 2. METHODS: A total of 22 patients underwent diagnostic needle arthroscopy of the shoulder, of whom 20 had preoperative MRI scans. A standardized 12-point noninstrumented diagnostic arthroscopy was performed on each patient using the 0° needle arthroscope, followed by a 30°, 4 mm–diameter conventional arthroscope. Intraoperative images were randomized and reviewed by 2 independent blinded fellowship-trained shoulder surgeons for identification of key pathology and anatomic structures. The MRI scans were reviewed by a single musculoskeletal radiologist to identify pathology in the same key areas. RESULTS: For the identification of rotator cuff pathology, needle arthroscopy (sensitivity, 0.75; specificity, 1.00) was superior to MRI (sensitivity, 0.75; specificity, 0.75) with an interobserver reliability (κ) of 0.703. For long head of the biceps pathology, needle arthroscopy (sensitivity, 0.67; specificity, 0.95) was superior to MRI (sensitivity, 0.00; specificity, 0.83). It was less accurate for labral (sensitivity, 0.33; specificity, 0.50; κ = 0.522) and articular cartilage pathology (sensitivity, 0.00; specificity, 0.94; κ = 0.353). The number of anatomic structures that could be clearly identified was 8.35 of 12 (69.58%) for needle arthroscopy versus 10.35 of 12 (86.25%) for standard arthroscopy. CONCLUSION: Diagnostic needle arthroscopy was found to be more accurate than MRI for the diagnosis of rotator cuff and long head of the biceps pathology but was less accurate for diagnosing labral and cartilage pathology. Although the field of view of a 0° needle arthroscope is not equivalent to a 30° conventional arthroscope, it presents an alternative with potential for use in an outpatient setting. SAGE Publications 2023-08-09 /pmc/articles/PMC10413894/ /pubmed/37576458 http://dx.doi.org/10.1177/23259671231155885 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/This article is distributed under the terms of the Creative Commons Attribution 4.0 License (https://creativecommons.org/licenses/by/4.0/) which permits any use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Article
Chowdhury, Alex
Gibson, Catherine
Nicholls, Alex
MacLeod, Iain
Colaco, Henry
Diagnostic Needle Arthroscopy of the Shoulder: A Validation Study
title Diagnostic Needle Arthroscopy of the Shoulder: A Validation Study
title_full Diagnostic Needle Arthroscopy of the Shoulder: A Validation Study
title_fullStr Diagnostic Needle Arthroscopy of the Shoulder: A Validation Study
title_full_unstemmed Diagnostic Needle Arthroscopy of the Shoulder: A Validation Study
title_short Diagnostic Needle Arthroscopy of the Shoulder: A Validation Study
title_sort diagnostic needle arthroscopy of the shoulder: a validation study
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10413894/
https://www.ncbi.nlm.nih.gov/pubmed/37576458
http://dx.doi.org/10.1177/23259671231155885
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