Article

OBJECTIVE: To determine the diagnostic accuracy of ultrasound for detecting
subacromial disorders in patients presenting in primary and secondary care
settings. DATA SOURCES: Medline and Embase were searched on June 9, 2010. In
addition, the reference list of 1 systematic review and all included articles
were searched to identify relevant studies. STUDY SELECTION: Two reviewers
independently selected the articles evaluating the accuracy of ultrasound for
detecting subacromial disorders from the title and abstracts retrieved by the
literature search. Selection criteria were ultrasound frequency greater than or
equal to 7.5MHz as index test, surgery, magnetic resonance imaging and/or
radiography as reference standards, and subacromial disorders as target
conditions. DATA EXTRACTION: Two reviewers independently extracted the data on
study characteristics and results to construct 2 by 2 tables and performed a
methodologic quality assessment. DATA SYNTHESIS: Twenty-three studies were
included: 22 reported on full-thickness rotator cuff tears, 15 on
partial-thickness tears, 3 on subacromial bursitis, 2 on tendinopathy, and 2 on
calcifying tendonitis, respectively. For full-thickness tears, pooled sensitivity
of ultrasound was .95 (95% confidence interval, .90-.97), and specificity .96
(.93-.98). For partial-thickness tears, pooled sensitivity was .72 (.58-.83), and
specificity .93 (.89-.96). Statistical pooling was not possible for the other
disorders. For subacromial bursitis, sensitivity ranged from .79 to .81, and
specificity from .94 to .98. For tendinopathy, sensitivity ranged from .67 to
.93, specificity from .88 to 1.00. Sensitivity for calcifying tendonitis was 1.00
in both studies, with specificity ranging from .85 to .98. CONCLUSIONS: We
strongly recommend ultrasound in patients for whom conservative treatment fails,
to rule in or out full-thickness tears, to rule in partial-thickness tears, and
to a lesser extent to diagnose tendinopathy, subacromial bursitis, and calcifying
tendonitis. These results can help physicians tailor treatment.
CI - Copyright (c) 2010 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS