Skeletal Radiology ( IF 1.9 ) Pub Date : 2022-03-19 , DOI: 10.1007/s00256-022-04036-2 Haron Obaid 1 , Prosanta Mondal 2 , Laura Sims 3 , Michael Shepel 1 , Nicholas Vassos 1
Objective
To describe MRI changes of the coracoclavicular bursa in patients presenting with shoulder pain and examine whether there is an association with coracoclavicular distance measurements.
Methods
Retrospective analysis of 198 shoulder 3T MRI scans for patients with shoulder pain was performed. Two musculoskeletal trained radiologists read all MRI scans. Inter-reader and intra-reader agreements for the bursal changes were assessed using the Kappa coefficient. The coracoclavicular distance was stratified into three intervals: < 5 mm, 5–10 mm, and > 10 mm. Statistical analysis for the coracoclavicular bursal changes and coracoclavicular distance was conducted using Fisher’s exact test.
Results
Coracoclavicular bursal changes were detected in 9% (n = 18/198) of patients. There was a statistically significant association between coracoclavicular distance (< 5 mm) and the presence of coracoclavicular bursal changes (p-value = 0.011). All patients (100%, n = 18/18) with coracoclavicular bursal fluid presented with shoulder pain with 44.5% of the patients (n = 8/18) describing anterior shoulder pain. A statistically significant association was detected between coracoclavicular bursal changes and anterior shoulder pain (p-value = 0.0011). Kappa coefficient for the bursal changes inter-reader agreement was moderate (0.67) and the intra-reader agreement was almost perfect (0.91).
Conclusion
Coracoclavicular bursal changes were detected in 9% of shoulder MRI scans and were associated with reduced coracoclavicular distance (< 5 mm) suggesting an underlying mechanical disorder such as a friction or an impingement process. Documenting coracoclavicular bursal changes in the MRI report could help address patients’ concerns and guide further management particularly in the context of shoulder pain and coracoclavicular distance of less than 5 mm.
中文翻译:
MRI 上喙锁囊变化:肩痛和喙锁距离缩短患者的诊断考虑
客观的
描述肩痛患者喙锁滑囊的 MRI 变化,并检查是否与喙锁距离测量相关。
方法
对 198 例肩部疼痛患者的肩部 3T MRI 扫描进行了回顾性分析。两名训练有素的肌肉骨骼放射科医生阅读了所有的 MRI 扫描。使用 Kappa 系数评估法氏囊变化的读者间和读者内协议。喙锁距离分为三个区间:< 5 mm、5-10 mm 和 > 10 mm。使用Fisher精确检验对喙锁囊变化和喙锁距离进行统计分析。
结果
9% ( n = 18/198) 的患者检测到喙锁法氏囊变化。喙锁距离(< 5 mm)与喙锁囊变化之间存在统计学显着关联(p值= 0.011)。所有患有喙锁法氏囊液的患者(100%,n = 18/18)都出现肩部疼痛,其中 44.5% 的患者(n = 8/18)描述了前肩部疼痛。在喙锁囊变化和前肩痛之间检测到统计学上显着的关联(p值= 0.0011)。法氏囊变化的 Kappa 系数读者间一致性适中(0.67),读者内一致性几乎完美(0.91)。
结论
在 9% 的肩部 MRI 扫描中检测到喙锁滑囊变化,并且与喙锁距离缩短(< 5 mm)相关,表明存在潜在的机械障碍,例如摩擦或撞击过程。在 MRI 报告中记录喙锁法氏囊的变化有助于解决患者的担忧并指导进一步的管理,特别是在肩痛和喙锁距离小于 5 mm 的情况下。