Article

The purposes of this study were to determine the best cutoff value for
bicipital peritendinous effusion (BPE) and to test its diagnostic performance as
regards shoulders with and without rotator cuff pathology. DESIGN: We reviewed
the sonographic reports of 1352 patients with suspected shoulder disorders
between January 2011 and June 2012. The associations between BPE and rotator cuff
abnormalities were explored by logistic regression and adjusted for age, sex,
affected side, and clinical diagnosis of frozen shoulder.
The receiver operating
characteristic curves were constructed to assess the ability of BPE to
discriminate certain rotator cuff pathologies. Maximal Youden indexes were used
to define the best cutoff points, which were later applied on the validation data
set for its discriminative ability. RESULTS: Sonographic findings of
subscapularis tendinopathy, subdeltoid bursitis, supraspinatus full-thickness
tear, and supraspinatus articular-sided partial-thickness tear were found to be
associated with BPE. The cutoff values of BPE to differentiate those lesions were
1.0, 0.9, 1.5, and 1.5 mm, respectively. Validation of the diagnostic performance
of BPE at defined thicknesses yielded good negative predictive values for the
aforementioned rotator cuff abnormalities. CONCLUSIONS: Sonographically detected
BPE seems to be in association with certain rotator cuff pathologies, and it can
be utilized as an adjuvant finding to rule out such rotator cuff abnormalities.
TO CLAIM CME CREDITS: Complete the self-assessment activity and evaluation online
at http://www.physiatry.org/JournalCME CME OBJECTIVES:: Upon completion of this
article, the reader should be able (1) to realize the association between the
biceps peritendinous effusion and other sonographic abnormal findings regarding
the shoulder joint, (2) to understand the possible mechanism of biceps
peritendinous effusion production, and (3) to use biceps peritendinous effusion
as an adjuvant finding to rule out rotator cuff abnormalities. LEVEL: Advanced
ACCREDITATION: : The Association of Academic Physiatrists is accredited by the
Accreditation Council for Continuing Medical Education to provide continuing
medical education for physicians. The Association of Academic Physiatrists
designates this activity for a maximum of 1.5 AMA PRA Category 1 Credit(s).
Physicians should only claim credit commensurate with the extent of their
participation in the activity.

Langue : ANGLAIS