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Beitragstitel Does “Wave”- and “Liquid”-sign in MRI help decision making in the diagnosis of AC dislocation: a retrospective correlation study.
Beitragscode P08
  1. Grégoire Thürig KS Schaffhausen
  2. Julien Galley
  3. Nermine Habib Swiss Diabetic Foot Centers Vortragender
  4. Paolo Fornaciari
  5. Mauro Maniglio
  6. Moritz Tannast HFR Fribourg - University of Fribourg
  7. Philippe Vial
Präsentationsform Poster
  • A01 - Schulter/Ellbogen
Abstract Background:
The diagnosis of AC joint dislocation is made by X-rays using the Rockwood classification. However, it gives only indirect information about the ligamentous injury. The treatment decision making is challenging for type II and III dislocations.
The purpose of this study is to evaluate the role of MRI in treatment decision making.
Examinations of all patients suffering from AC joint trauma were randomised and retrospectively rated by two residents and two consultants blinded to the chosen treatment. This retrospective study includes all who suffered a trauma to the AC joint and were investigated with conventional X-rays (anteroposterior and Zanca) and MRI at our institution between 2015 and 2019. AC dislocation was defined using Rockwood classification on X-ray and ligaments were assessed on MRI.
The reproducibility and reliability were assessed using weighted kappa. The correlation of surgical treatment using MRI and the operative treated patients was calculated using phi and maximum difference.
50 patients (mean 39yo) were included. 9 were graded Rockwood Type I, 10 Type II, 19 Type III, and 12 Type V. Due to clinical evaluation, no Type I, 4 Type II, 17 Type III and 12 Type V had surgery.
The reproducibility of the Rockwood classification was almost perfect, but the reliability was moderate. The reproducibility of the lesions of the AC joint was slight to almost perfect and the reliability slight to moderate. The reproducibility of both “Wave”- and “Liquid”-sign was almost perfect, and the reliability was almost perfect and substantial, respectively.
The calculated correlation phi of positive “Wave”- and “Liquid”-sign and performed surgical treatment was phi = 0.626. The maximum difference was 63,2%. The positive correlation of the two positive signs (“Wave” and “Liquid”) indicating surgical treatment and the patients who had surgery was strong and high significant (p = 0.000), meaning a positive association. In cases of RW Type V or Type I phi resulted in an absolute constant.
MRI gives us more reliable information about the status of CC ligaments and concomitant injuries. Both the “Wave”-sign and the “Liquid”-sign were present in patients who showed instability and underwent surgical treatment.
The benefit of MR-diagnosis in decision-making seems of great value, particularly for Rockwood Type II and III, and would allow more accurate decision-making to avoid a delay in surgical treatment when necessary.