COMPARISON OF COMPLEMENTARY EXAMS IN THE DIAGNOSIS OF ROTATOR CUFF INJURIES.

UNLABELLED: The aim of this study was to evaluate the accuracy of simple radiography, ultrasound and magnetic resonance imaging (MRI) in diagnosing rotator cuff injuries, comparing their findings with open or arthroscopic surgery findings. METHODS: Protocols of the Shoulder and Elbow Surgery Service for patients undergoing surgical treatment for rotator cuff injuries diagnosed by means of radiography, ultrasound and/or MRI between 2002 and 2007 were evaluated. Based on the data gathered, we analyzed the sensitivity, specificity, positive predictive value, negative predictive value and accuracy of these complementary examinations, compared with the findings during the surgical procedures. RESULTS: This study included 147 patients with a mean age of 46.09 years. All the patients had undergone a radiography examination, 101 had undergone ultrasound examination and 72 had undergone MRI. We found sensitivity of 13.8%, specificity of 2.6% and accuracy of 30% with radiography; sensitivity of 57.6%, specificity of 29.6% and accuracy of 51.4% with ultrasound; and sensitivity of 86.6%, specificity of 22.2% and accuracy of 63.3% with MRI. CONCLUSION: Radiography was found to be a specific examination when the mirror sign was present. MRI and ultrasound were shown to be reliable methods with high accuracy for diagnosing rotator cuff injuries.

GORHAM-STOUT SYNDROME: PHANTOM BONE DISEASE.

Gorham-Stout syndrome is a disease that presents idiopathic osteolysis of a bone or closely contiguous area. The etiology is unknown. It is a rare condition that is difficult to diagnose, and its treatment is controversial. It affects individuals irrespective of age or sex. In this study, we conducted a bibliographic review of the disease, specifically focusing on the differential diagnosis, and we demonstrated the follow-up on a patient with this syndrome from the time of its diagnosis, through treatment, to its current state of evolution.

Comparação dos exames complementares no diagnóstico das lesões do manguito rotador / Comparison of complementary exams in the diagnosis of rotator cuff injuries

OBJETIVO: A proposta do trabalho é avaliar a acurácia da radiografia simples, ultrassonografia e ressonância nuclear magnética no diagnóstico das lesões do manguito rotador, comparando-os com os achados em cirurgias abertas ou artroscópicas. Métodos: Foram avaliados protocolos do Serviço de Cirurgia do Ombro e Cotovelo dos pacientes submetidos ao tratamento cirúrgico por lesão de manguito rotador diagnosticados por radiografia, ultrassom e/ou ressonância no período de 2002-2007. Com base nos dados coletados, analisamos a sensibilidade, especificidade, valor preditivo positivo, valor preditivo negativo e acurácia destes exames complementares, comparados aos achados durante os procedimentos cirúrgicos. RESULTADOS: Foram incluídos no estudo 147 pacientes, com média de idade de 46,09 anos. Todos os pacientes estudados haviam realizado um exame de radiografia, 101 apresentavam ultrassonografia e 72 pacientes realizaram ressonância magnética. Encontramos sensibilidade de 13,8 por cento, especificidade de 2,6 por cento e acurácia de 30 por cento com a radiografia; sensibilidade de 57,6 por cento, especificidade de 29,6 e acurácia de 51,4 por cento com o ultrassom; e sensibilidade de 86,6 por cento, especificidade de 22,2 por cento e acurácia de 63,3 por cento com a ressonância. CONCLUSÃO: A radiografia se mostrou um exame específico quando apresentou sinal do espelho. A ressonância e a ultrassonografia se mostraram métodos confiáveis apresentando elevada acurácia no diagnóstico das lesões do manguito rotador.

OBJECTIVE: This paper proposes to evaluate the accuracy of x-rays, ultrasounds, and nuclear magnetic resonance in the diagnosis of rotator cuff injuries, comparing their findings with open surgery or arthroscopic findings. METHODS: Shoulder and Elbow Surgery Department protocols for patients undergoing surgical treatment for rotator cuff injury diagnosed by x-ray, ultrasound and/or resonance in our clinic, that were between 2002 and 2007. Based on the data collected, we analyzed the sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of these complementary exams, compared to the findings from surgical procedures. RESULTS: The study included 147 patients with a mean age of 46.09 years. Every patient had completed an x-ray exam, 101 had had an ultrasound and 72 patients underwent magnetic resonance. We found a sensitivity of 13.8 percent, specificity of 2.6 percent, and accuracy of 30 percent with the x-rays; a sensitivity of 57.6 percent, specificity of 29.6 percent, and accuracy of 51.4 percent with the ultrasound; and a sensitivity of 86.6 percent, specificity of 22.2 percent, and accuracy of 63.3 percent with magnetic resonance. CONCLUSIONS: X-rays showed specificitywhen the mirror sign was present. Magnetic resonance and ultrasound demonstrated themselves to be reliable methods with high accuracy for rotator cuff injury diagnosis.

Síndrome de Gorham-Stout: doença do osso fantasma / Gorham-Stout syndrome: phantom bone disease

A síndrome de Gorham-Stout é uma doença que apresenta osteólise idiopática de um osso ou área contígua próxima. A etiologia é desconhecida, sendo uma condição rara, de difícil diagnóstico e tratamento controverso. Acomete pessoas sem distinção quanto à idade e ao sexo. Neste trabalho realizamos uma revisão bibliográfica da doença, dando enfoque específico no diagnóstico diferencial, e demonstramos o acompanhamento de um paciente com esta síndrome, desde o seu diagnóstico, tratamento e estado atual de evolução.

Gorham-stout syndrome is a disease that presents idiopathic osteolysis of a bone or contiguous area. The etiology is unknown. It is a rare condition, difficult to diagnose and with controversial treatment. This condition affects persons with no distinction as to age or sex. In this study, we conduct a bibliographic review of the disease, specifically focusing on differential diagnosis, and follow a patient with this syndrome from the time of its diagnosis, through treatment, to its current state of evolution.