The role of grey-scale ultrasound in the diagnosis of adhesive capsulitis of the shoulder: a systematic review and meta-analysis.

Wu H, Tian H, Fajin Dong, Liang W, Song D, Zeng J, Ding Z, Shi Y, Luo H, Xu J
Medical ultrasonography · 2020 · doi:10.11152/mu-2430 · PMID:32399538
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This systematic review and meta-analysis evaluated the diagnostic accuracy of grey-scale ultrasonography for adhesive capsulitis of the shoulder, utilizing magnetic resonance imaging or arthroscopy as reference standards across seven studies involving 490 shoulders. The results demonstrated high overall sensitivity (88%) and specificity (96%), with specific ultrasound features such as coracohumeral ligament thickening and inferior capsule thickening showing strong diagnostic performance. The authors concluded that due to these robust metrics, grey-scale ultrasound is a significant tool that can be effectively integrated into existing clinical diagnosis programs for this condition. The paper does not explicitly discuss endometriosis or adenomyosis; it was included in the corpus via a keyword match in the upstream search index.

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Abstract

AimsIn this systematic review and meta-analysis, we discuss the value of grey-scale ultrasonography (US) in diagnosing adhesive capsulitis of the shoulder (ACS).Material and methodsWe retrieved relevant studies from PubMed, Cochrane Library, and Embase before 8 April 2019. We selected 7 studies concerning 446 patients (490 shoulders) that used grey-scale US to diagnose ACS and magnetic resonance imaging (MRI) or arthroscopy as the reference standard. We assessed the diagnostic accuracy of US on the basis of combined sensitivity, specificity, likelihood ratio (LR), and the area under the summary receiver operating characteristic (SROC) curve (AUC).ResultsThe combined sensitivity, specificity, positive LR and negative LR were found to be 88% (95%CI: 74-95), 96% (95%CI: 88-99), 23.89 (95%CI: 6.31-90.51) and 0.12 (95%CI: 0.05-0.29), respectively. The AUC was 0.97 (95%CI: 0.96-0.98). ACS was diagnosed on the basis of four US features: coracohumeral ligament thickening, inferior capsule/axillary recess capsule thickening, rotator interval abnormality, and restriction of the range of motion. The corresponding sensitivities were 64.4 (95%CI: 48.8-78.1), 82.1 (95%CI: 73.8-88.7), 82.6 (95%CI: 74.1-89.2) and 94.3 (95%CI: 84.3-98.8), respectively, and specificities were 88.9 (95%CI: 76.0-96.3), 95.7 (95%CI: 90.3-98.6), 93.9 (95%CI: 89.8-96.7), and 90.9 (95%CI: 75.7-98.1), respectively.ConclusionsOur meta-analysis showed that grey-scale US plays a significant role in the diagnosis of ACS. Because of its high sensitivity and specificity, US can be added to the existing clinical diagnosis program.
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Abstract

Aims: In this systematic review and meta-analysis, we discuss the value of grey-scale ultrasonography (US) in diagnosing adhesive capsulitis of the shoulder (ACS).

Material and methods

We retrieved relevant studies from PubMed, Cochrane Library, and Embase before 8 April 2019. We selected 7 studies concerning 446 patients (490 shoulders) that used grey-scale US to diagnose ACS and magnetic resonance imaging (MRI) or arthroscopy as the reference standard. We assessed the diagnostic accuracy of US on the basis of combined sensitivity, specificity, likelihood ratio (LR), and the area under the summary receiver operating characteristic (SROC) curve (AUC).

Results

The combined sensitivity, specificity, positive LR and negative LR were found to be 88% (95%CI: 74–95), 96% (95%CI: 88–99), 23.89 (95%CI: 6.31–90.51) and 0.12 (95%CI: 0.05–0.29), respectively. The AUC was 0.97 (95%CI: 0.96–0.98). ACS was diagnosed on the basis of four US features: coracohumeral ligament thickening, inferior capsule/axillary recess capsule thickening, rotator interval abnormality, and restriction of the range of motion. The corresponding sensitivities were 64.4 (95%CI: 48.8–78.1), 82.1 (95%CI: 73.8–88.7), 82.6 (95%CI: 74.1–89.2) and 94.3 (95%CI: 84.3–98.8), respectively, and specificities were 88.9 (95%CI: 76.0–96.3), 95.7 (95%CI: 90.3–98.6), 93.9 (95%CI: 89.8–96.7), and 90.9 (95%CI: 75.7–98.1), respectively.

Conclusions

Our meta-analysis showed that grey-scale US plays a significant role in the diagnosis of ACS. Because of its high sensitivity and specificity, US can be added to the existing clinical diagnosis program. DOI: http://dx.doi.org/10.11152/mu-2430 Refbacks - There are currently no refbacks.

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