Correlation of findings in MRI of the shoulder with acromioclavicular joint pain

Congress:

ECR 2019

Poster Number:

C-2446

Type:

Scientific Exhibit

Keywords:

Musculoskeletal joint, Bones, MR, Diagnostic procedure, Arthritides, Oedema

Authors:

J. Neubauer, T. Yilmaz, D. Maier; Freiburg/DE

DOI:

10.26044/ecr2019/C-2446

DOI-Link:

https://dx.doi.org/10.26044/ecr2019/C-2446

Fig. 1: Imaging example for an effusion in the acromioclavicular joint (axial PD fs).

Fig. 2: Imaging example for an effusion in the acromioclavicular joint (coronal STIR).

Fig. 3: Imaging example for an effusion in the acromioclavicular joint (sagittal T2).

Aims and objectives

To evaluate the inter-rater reliability and correlation of reliable imaging features in magnetic resonance imaging (MRI) of the shoulder with clinical tests for acromioclavicular joint pain. Our hypothesis is that reliable imaging features in shoulder MRI correlate with clinical tests for acromioclavicular (AC) joint pain.

Methods and materials

Over a period of 1 year this IRB approved prospective study included patients who presented to our outpatient clinic with shoulder pain of unknown origin and who had previously undergone MRI of the shoulder for this reason. MRI had been performed in multiple different institutions. An orthopedic surgeon performed O´Brien´s Test1, Paxinos Test2, Cross Body Adduction Test1 and AC joint tenderness test1 in all patients resulting in a score from 0 (no test positive) to 4 (all tests positive). 3 raters experienced in the evaluation...

Results

57 patients were included in this study. Moderate inter-rater reliability was achieved for the measured extent of edema in the lateral clavicle, subchondral cysts and joint effusion. These imaging features were therefore considered to be reliable. Of these reliable imaging features, only AC joint effusion (imaging examples Fig. 1-3) correlated significantly with positive clinical test results with a proportional odds ratio of 3.9 (95%CI: 1.9-8.4/ P<0.001). All other features showed no significant correlation to the clinical tests (P>0.28).

Conclusion

AC joint effusion detected in MRI shows a correlation with clinical tests for acromioclavicular joint pain. These results may help imaging interpreters to aid appropriate patient management when reporting on AC joint related changes in MRI of the shoulder.

Personal information

References

1: Cadogan A, McNair P, Laslett M, Hing W. Shoulder pain in primary care: diagnostic accuracy of clinical examination tests for non-traumatic acromioclavicular joint pain. BMC Musculoskelet Disord. 2013 May 1;14:156. doi: 10.1186/1471-2474-14-156. PubMed PMID: 23634871; PubMed Central PMCID: PMC3646690. 2: Walton J, Mahajan S, Paxinos A, Marshall J, Bryant C, Shnier R, Quinn R, Murrell GA. Diagnostic values of tests for acromioclavicular joint pain. J Bone Joint Surg Am. 2004 Apr;86-A(4):807-12. PubMed PMID: 15069148.