dc.contributor.author | Nabieu, P. F. | |
dc.contributor.author | Mwangi, J. C. | |
dc.contributor.author | Oburu, C. O | |
dc.contributor.author | [et.al] | |
dc.date.accessioned | 2021-04-26T13:41:27Z | |
dc.date.available | 2021-04-26T13:41:27Z | |
dc.date.issued | 2021-04-09 | |
dc.identifier.citation | Nabieu, P. F., Mwangi, J. C., Oburu, C. O., Sitati, F., Gakuya, E. M., & Mutiso, V. M. (2021). A multicenter study comparing the accuracy of MRI to arthroscopy for the diagnosis of glenohumeral joint pathologies. East African Orthopaedic Journal, 15(1), 10-17. | en_US |
dc.identifier.uri | https://www.ajol.info/index.php/eaoj/article/view/205699 | |
dc.identifier.uri | http://erepository.uonbi.ac.ke/handle/11295/154904 | |
dc.description.abstract | Background: The number of patients with shoulder pathology who seek medical treatment is on
the increase. It affects approximately18-26% of adult population. The symptoms can sometimes be
debilitating affecting not only the person’s occupation but also activities of daily living. Among the
diagnostic modalities for glenohumeral pathologies, clinical examination remains the key but MRI
and arthroscopy are more accurate and can play a complimentary role. The MRI is highly sensitive,
specific, non-invasive with no radiation. On the contrary, shoulder arthroscopy is considered to be
the “Gold Standard” for diagnosis and treatment of glenohumeral joint pathologies. It is accurate and
less invasiveness compared to open shoulder surgery. However, it is expensive.
Objective: The aim was to determine the degree of accuracy of MRI compared to arthroscopy in the
diagnosis of glenohumeral joint pathologies.
Design: A multicenter prospective consecutive cross-sectional study. The sites included: The Nairobi,
Aga Khan University, Mater, Kikuyu, Kijabe, Coptic and MP Shah hospitals.
Methodology: The patients with traumatic soft tissue injury or degenerative syndromes of the
glenohumeral joint were recruited over a period of 8 months. Clinical examinations were done
followed by MRI and then arthroscopy. The SPSS version 25 computer software was used to code the
collected data. The final results were presented in charts, tables and graphical forms. The Sensitivity,
Specificity, PPV, and NPV were calculated to determine the accuracy of the MRI and clinical
examination. This were compared to the findings of arthroscopy. For the categorical variables, chisquare test was used. The P value < 0.05 was considered significant.
Results: The sample size was 74 participants. The age range was 16 to 73 years with an average of
48 years. The male to female ratio was 1:1. Majority 46 (62%) of the patients had joint pathology
on the right side while 28(37.8%) was on the left. This might be related to hand dominance. The
three modalities of investigations found the frequencies of the glenohumeral joint pathologies are
as follows. The Rotator Cuff Tears ranged from 35 to 42 (47.3% to 56.8%), Subacromial Impingement
Syndrome ranged from 21-24 (28.4 % to 32.4%), and Bankart lesions ranged from 9-10 (12.2 % to
13.5%). The result revealed a strong positive relationship between MRI and arthroscopic finding for
Rotator Cuff Tear (r = 0.663, p<0.05), Subacromial Impingement Syndrome (r = 0.652, p<0.05) and
Bankart lesion (r = 0.699). However, the clinical examination showed a moderate positive relationship
for Rotator Cuff Tear (r =0.46, p<0.05) and Subacromial Impingement Syndrome (r = 0.445, p<0.05).
The sensitivity for MRI ranges from 0.7 for Bankart lesions to 0.914 for Rotator Cuff Tears. Furthermore,
the positive predictive value was 0.762 (76%) for Rotator cuff tear and 0.8 (80%) for Subacromial
Impingement Syndrome.
Conclusion: The study revealed a significant correlation between clinical examination, MRI and
arthroscopy for the diagnosis of glenohumeral pathologies. Both MRI and clinical examination are
complimentary to each other. Consequently, in low income countries, arthroscopy can be done after
thorough clinical examination without preliminary MRI in resources limited situations based on the
resolution of the surgeon | en_US |
dc.language.iso | en | en_US |
dc.publisher | East African Orthopaedic Journal | en_US |
dc.subject | Glenohumeral, MRI, Arthroscopy, Clinical examination, Rotator Cuff Tears | en_US |
dc.title | A multicenter study comparing the accuracy of MRI to arthroscopy for the diagnosis of glenohumeral joint pathologies | en_US |
dc.type | Article | en_US |