2021 ISAKOS Biennial Congress ePoster
Diagnostic Value Of Various Measurement Methods For Hill-Sachs Lesions
Mirco Sgroi, MD, Ulm GERMANY
Hashuka Huzurudin, MD, Ulm GERMANY
Marius Ludwig, MD, Ulm GERMANY
Michael Fuchs, Dr., Ulm GERMANY
Heiko Reichel, Prof., Ulm GERMANY
Thomas Kappe, MD, Prof., Ulm GERMANY
Department for Orthopaedic Surgery, RKU, University of Ulm, Ulm, Germany, Ulm, GERMANY
FDA Status Not Applicable
Summary
Measurement Methods for Hill-Sachs Lesions
ePosters will be available shortly before Congress
Abstract
Background
Accurate detection and measuring of Hill-Sachs lesions (HSLs) is fundamental for planning adequate surgical treatment. However, very few studies have investigated the diagnostic value of imaging and measuring techniques for HSLs.
Hypothesis/purposes: The aim of the current study was to investigate the diagnostic value of anterior-posterior (AP) view and Stryker Notch (SN) view radiographs, computed tomography (CT), and magnetic resonance imaging (MRI) in detecting and quantifying HSLs.
Methods
A total of 80 consecutive patients with histories of anterior shoulder instability were retrospectively included. The preoperative AP and SN radiographs, CT, and MRI scans of the affected shoulders were analyzed. To assess the sensitivity (SE), specificity (SP), positive (PPV) and negative (NPV) predictive values, accuracy (AC), diagnostic odds ratio (DOR), positive (LR+) and negative (LR-) likelihood ratios, and area under the curve (AUC), the radiological findings were compared with the arthroscopic results. Two observers measured the amount of humeral bone loss using different techniques and imaging modalities.
Results
Significant correlations among the SN radiographs (p = 0.005), CT (p =0.0001), MRI (p = 0.0002), and intraoperative findings were found. The MRI showed a higher AUC (0.764) compared to the CT (0.755) and SN (0.726). The use of SN radiographs was found to significantly underestimate HSLs compared to CT in all measurements performed. A significant difference was found between CT and MRI in the determination of the Hill-Sachs interval (HSI), but not between any of the other measurement techniques. With the exceptions of the Franceschi and Calandra classification, all measurement methods performed showed excellent intra- and inter-rater reliability for both MRI and CT.
Conclusions
SN radiographs are a reliable method for detecting HSL, although they are not adequate for the measurement thereof. The almost identical AUCs and the correlation with arthroscopic findings suggest that both CT and MRI could be considered as a gold standard for the detection of HSLs. While the determination of the HSI seems to be more accurate with MRI, the measuring technique developed by Hall, Rowe, Richards, and Flatow can be performed with the same precision using CT or MRI.