New quantitative method to measure the Hill-Sachs lesion: validation of Hardy's radiographic method for MRI/AMRI

França, Flávio de Oliveira; Godinho, André; Ribeiro, Elisio; Ranzzi, Abel; Bittencourt, Brício Lima Lobão; Barreto, Bruno Brum

doi:10.1016/j.rboe.2018.07.012

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Sumário

Artigos Originais • Rev. bras. ortop. 53 (5) • Sep-Oct 2018 • https://doi.org/10.1016/j.rboe.2018.07.012 copy

New quantitative method to measure the Hill-Sachs lesion: validation of Hardy's radiographic method for MRI/AMRI^☆ ☆ Study conducted at Hospital Ortopédico de Belo Horizonte, Belo Horizonte, MG, Brazil.

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective:

To validate Hardy's radiographic method for magnetic resonance imaging/magnetic resonance arthrography (MRI/MRA) in the assessment of Hill-Sachs lesion (HSL) involvement in patients with a history of anterior shoulder instability.

Methods:

This study retrospectively evaluated 53 shoulder radiographs and MRI/MRA to compare the measurements of HSL through Hardy's radiographic method. Imaging exams used in the study were conducted between the March 2013 AND September 2015. The data obtained from these exams were carried out during 2015. Inclusion criteria were previous history of anterior instability of the shoulder, presence of LHS, and radiographs at 70° medial rotation.

Results:

MRI/MRA had a sensitivity of 100% and specificity of 100% when using the Hardy's radiographic method 20% cutoff point to measure the HSL.

Conclusion:

MRI/MRA can be used to assess the degree of HSL involvement with the same reliability as Hardy's radiographic method.

Keywords:
Instability indexes; Shoulder dislocation; Magnetic resonance imaging

Hardy index (%)	Sensitivity	Confidence interval (95%)	Specificity	Confidence interval (95%)
≥5	100	79.4–100.0	0	0.0–9.5
>5	100	79.4–100.0	2.7	0.07–14.2
>8	100	79.4–100.0	5.41	0.7–18.2
>9	100	79.4–100.0	10.81	3.0–25.4
>10	100	79.4–100.0	16.22	6.2–32.0
>11	100	79.4–100.0	21.62	9.8–38.2
>12	100	79.4–100.0	27.03	13.8–44.1
>13	100	79.4–100.0	40.54	24.8–57.9
>14	100	79.4–100.0	51.35	34.4–68.1
>15	100	79.4–100.0	64.86	47.5–79.8
>16	100	79.4–100.0	72.97	55.9–86.2
>17	100	79.4–100.0	83.78	68.0–93.8
>18	100	79.4–100.0	86.49	71.2–95.5
>19	100	79.4–100.0	91.89	78.1–98.3
>20	100	79.4–100.0	100	90.5–100.0
>21	81.25	54.4–96.0	100	90.5–100.0
>22	62.5	35.4–84.8	100	90.5–100.0
>23	50	24.7–75.3	100	90.5–100.0
>27	37.5	15.2–64.6	100	90.5–100.0
>28	31.25	11.0–58.7	100	90.5–100.0
>29	25	7.3–52.4	100	90.5–100.0
>33	18.75	4.0–45.6	100	90.5–100.0
>34	12.5	1.6–38.3	100	90.5–100.0
>35	6.25	0.2–30.2	100	90.5–100.0
>36	0	0.0–20.6	100	90.5–100.0

Sociedade Brasileira de Ortopedia e Traumatologia Al. Lorena, 427 14º andar, 01424-000 São Paulo - SP - Brasil, Tel.: 55 11 2137-5400 - São Paulo - SP - Brazil
E-mail: rbo@sbot.org.br

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[1] *Corresponding author. E-mail: flavio.franca29@gmail.com (F.O. França).

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New quantitative method to measure the Hill-Sachs lesion: validation of Hardy's radiographic method for MRI/AMRI☆ ☆ Study conducted at Hospital Ortopédico de Belo Horizonte, Belo Horizonte, MG, Brazil.

ABSTRACT

Objective:

Methods:

Results:

Conclusion:

New quantitative method to measure the Hill-Sachs lesion: validation of Hardy's radiographic method for MRI/AMRI^☆ ☆ Study conducted at Hospital Ortopédico de Belo Horizonte, Belo Horizonte, MG, Brazil.