Accuracy of shoulder ultrasound examination for diagnosis of rotator cuff pathologies: a single-center retrospective study.

BACKGROUND: Shoulder pathologies need accurate diagnosis for best management and treatment provided to patients. OBJECTIVE: Determine the diagnostic sensitivity, specificity and accuracy of shoulder ultrasonography (US). DESIGN: Retrospective, analytical. SETTING: Tertiary care center in Riyadh, Saudi Arabia. PATIENTS AND METHODS: We included all shoulder exams performed between January 2010 and December 2016 that met the inclusion criteria. Data was collected retrospectively from the a picture archiving and communication system and patient records. The patients were evaluated using US for the presence of rotator cuff tears and classified into intact, full-thickness tear, partial-thickness tear, tendinosis, subacromial/subdeltoid bursitis and acromioclavicular joint degenerative changes. The US findings were correlated with the shoulder MRI study findings. The time interval between the US examination and MRI ranged from 0 to 180 days (6 months). MAIN OUTCOME MEASURES: To compare the sensitivity, specificity and accuracy of shoulder US studies in the detection of rotator cuff pathologies in comparison to MRI findings. SAMPLE SIZE AND CHARACTERISTICS: 86 (60 females, 26 male), mean age 53.7 years (range, 19-85). RESULTS: The sensitivity, specificity and accuracy of US for the detection of full-thickness supraspinatus tears compared with those of MRI were 86%, 82% and 83%, respectively. The sensitivity, specificity and accuracy of US for the detection of partial-thickness supraspinatus tears compared with those of MRI were 38%, 70% and 58%, respectively. Overall PPV, NPV, sensitivity, specificity and accuracy of US for the detection of full-thickness tears compared with those of MRI were 35%, 97%, 78%, 83% and 83%, respectively. For partial-thickness tears, the overall PPV, NPV, sensitivity, specificity and accuracy of US compared with those of MRI were 51%, 60%, 51%, 60% and 56%, respectively. CONCLUSION: Overall, US has high sensitivity, specificity and accuracy for the detection of full-thickness tears compared with the detection of partial-thickness tears. LIMITATIONS: Small sample size and retrospective. CONFLICT OF INTEREST: None.

Sonographic measurements for kidney length in normal Saudi children: correlation with other body parameters.

BACKGROUND: Ultrasonography provides a quick assessment of visceral organ dimensions without any risk of radiation. Since many diseases can affect the kidney size, having a reliable reference for kidney length in children is valuable for clinical assessment. OBJECTIVE: Establish normal growth curves for renal length in relation to sex, age, body weight, height, body mass index and body surface area of healthy children in Saudi Arabia. DESIGN: Retrospective review of ultrasonography images. SETTING: Tertiary referral hospital. PATIENTS AND METHODS: We included all normal ultrasonography exams of renal length from full-term neonates to children ≤14 years old performed between 2003 and 2018. Data was collected retrospectively from the electronic archive and patient records. MAIN OUTCOME MEASURES: Relationship between the longitudinal length of both kidneys and age, height, weight, body mass index and body surface area. SAMPLE SIZE: 950 patients. RESULTS: The left kidneys were longer than the right kidneys ( P<.001). Height had the most significant correlation with kidney length (R2=0.829, P<.001 for right kidney; R2=0.831, P<.001 for left kidney). There was a consistent difference in kidney length by sex. Both kidneys were longer in males than females ( P=.031, right kidney:, P=.015, left kidney). In terms of renal growth by age, our data showed a statistically significant difference before and after 24 months of age. There was no significant difference between populations from Saudi Arabia, Hong Kong ( P=.485) and Australia ( P=.99), but the difference between Saudi and American children was significant ( P<.001). However, we did not have the data from those studies for direct comparison. The correlation plots of renal length versus age for all four countries were similar. CONCLUSION: The tables and correlation plots generated from this study should be useful to radiology departments in assessing conditions in children ≤14 years of age that lead to changes in renal size. LIMITATIONS: Retrospective, and there were differences in ultrasonographic techniques for patient positioning and cursor placement that can affect the reproducibility of measurements of renal length. CONFLICT OF INTEREST: None.