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首页> 外文期刊>Journal of athletic training >Validity of musculoskeletal ultrasound for identification of humeroradial joint chondral lesions: A preliminary investigation
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Validity of musculoskeletal ultrasound for identification of humeroradial joint chondral lesions: A preliminary investigation

机译：肌肉骨骼超声在确定肱骨radi关节软骨病变中的有效性：初步调查

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Context: Epicondylalgia is a common condition involving pain-generating structures such as tendon, neural, and chondral tissue. The current noninvasive reference standard for identifying chondral lesions is magnetic resonance imaging. Musculoskeletal ultrasound (MUS) may be an inexpensive and effective alternative. Objective: To determine the intrarater reliability and validity of MUS for identifying humeroradial joint (HRJ) chondral lesions. Design: Cross-sectional study. Setting: Clinical anatomy research laboratory. Patients or Other Participants: Twenty-eight embalmed cadavers (14 women, 14 men; mean age = 79.5 ± 8.5 years). Main Outcome Measure(s): An athletic trainer performed MUS evaluation of each anterior and distal-posterior capitellum and radial head to identify chondral lesions. The reference standard was identification of chondral lesions by gross macroscopic examination. Intrarater reliability for reproducing an image was calculated using the intraclass correlation coefficient (3,k) for measurements of the articular surface using 2 images. Intrarater reliability to evaluate a single image was calculated using the Cohen j for agreement as to the presence of chondral lesions. Validity was calculated using the agreement of MUS images and gross macroscopic examination. Results: Intrarater reliability was 0.88 (95% confidence interval = 0.77, 0.94) for reproducing an image and 0.93 (95% confidence interval = 0.80, 1.06) for evaluating a single image. Identifying chondral lesions on all HRJ surfaces with MUS demonstrated sensitivity = 0.93, specificity = 0.28, positive predictive value=0.58, negative predictive value=0.77, positive likelihood ratio = 1.28, and negative likelihood ratio = 0.27. Conclusions: Musculoskeletal ultrasound is a reliable and sensitive tool for a clinician with relatively little experience and training to rule out HRJ chondral lesions. These results may assist with clinical assessment and decision making in patients with lateral epicondylalgia to rule out HRJ chondral lesions.
机译：背景：上con痛是一种常见的疾病，涉及诸如肌腱，神经和软骨组织等产生疼痛的结构。当前用于识别软骨损伤的非侵入性参考标准是磁共振成像。肌肉骨骼超声（MUS）可能是一种廉价而有效的替代方法。目的：确定MUS在鉴别肱radi骨关节（HRJ）软骨病变中的信度和信度。设计：横断面研究。地点：临床解剖学研究实验室。患者或其他参与者：28名防腐尸体（14名女性，14名男性;平均年龄= 79.5±8.5岁）。主要观察指标：运动训练者对每个前后和前后-骨和ite骨头进行MUS评估，以识别软骨病变。参考标准是通过肉眼肉眼检查鉴定软骨病变。使用类内相关系数（3，k）计算用于复制图像的帧内可靠性，该类内相关系数用于使用2幅图像测量关节表面。使用Cohen j得出评估软骨损伤的一致性的评估者内部评估单个图像的可靠性。使用MUS图像和宏观肉眼检查的一致性来计算有效性。结果：对于复制图像，评估者内部可靠性为0.88（95％置信区间= 0.77，0.94），对于评估单个图像，其内部可靠性为0.93（95％置信区间= 0.80，1.06）。用MUS鉴定所有HRJ表面的软骨损伤显示灵敏度= 0.93，特异性= 0.28，阳性预测值= 0.58，阴性预测值= 0.77，阳性似然比= 1.28，阴性似然比= 0.27。结论：肌肉骨骼超声对于缺乏经验和培训以排除HRJ软骨病变的临床医生而言是一种可靠而敏感的工具。这些结果可能有助于外侧上con痛患者的临床评估和决策，以排除HRJ软骨病变。

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