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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...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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SAGE Publications
2023
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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. |
format | Online Article Text |
id | pubmed-10413894 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | SAGE Publications |
record_format | MEDLINE/PubMed |
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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