Predictive MRI correlates of lesser metatarsophalangeal joint plantar plate tear.
Purpose: To identify correlated signs on non-enhanced MRI that might improve diagnostic detection of plantar plate (PP) tear.Materials and Methods: We performed an IRB-approved, HIPAA-compliant retrospective analysis of 100 non-contrast MRI (50 PP tear, 50 controls). All were anonymized, randomized,...
| Publicado en: | Skeletal Radiology Vol. 45; no. 7; pp. 969 - 976 |
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| Autores principales: | , , , , , |
| Formato: | Journal Article |
| Publicado: |
Springer Nature
Jul2016
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=115528473&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 115528473 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 03642348 O14 jtl: Skeletal Radiology issn: 03642348 maglogo: N pubinfo: dt: Jul2016 vid: 45 iid: 7 pid: 237 pub: Springer Nature place: New York, New York artinfo: ui: 115528473 115528473 NLM27056600 10.1007/s00256-016-2375-x NLM27056600 115528473 ppf: 969 ppct: 7 formats: fmt: @attributes: type: P tig: atl: Predictive MRI correlates of lesser metatarsophalangeal joint plantar plate tear. aug: au: Umans, Rachel Umans, Benjamin Umans, Hilary Elsinger, Elisabeth Umans, Rachel L Umans, Benjamin D affil: Cornell University Medical College, New York USA sug: subj: Foot Injuries Metatarsophalangeal Joint Injuries Magnetic Resonance Imaging Case Control Studies Joint Instability Algorithms Middle Age Male Decision Trees Adult Female Retrospective Design Metatarsophalangeal Joint Middle Aged: 45-64 years Adult: 19-44 years Male Female ab: Purpose: To identify correlated signs on non-enhanced MRI that might improve diagnostic detection of plantar plate (PP) tear.Materials and Methods: We performed an IRB-approved, HIPAA-compliant retrospective analysis of 100 non-contrast MRI (50 PP tear, 50 controls). All were anonymized, randomized, and reviewed; 20 were duplicated to assess consistency. One musculoskeletal radiologist evaluated qualitative variables. A trained non-physician performed measurements. Consistency and concordance were assessed. Pearson's Chi-square test was used to test the correlation between qualitative findings and PP tear status. Correlation between measurements and PP status was assessed using t tests and Wilcoxon's rank-sum test (p values < 0.05 considered significant). Classification and regression trees were utilized to identify attributes that, taken together, would consistently distinguish PP tear from controls.Results: Quantitative measurements were highly reproducible (concordance 0.88-0.99). Elevated 2nd MT protrusion, lesser MT supination and rotational divergence of >45° between the 1st-2nd MT axis correlated with PP tear. Pericapsular soft tissue thickening correlated most strongly with PP tear, correctly classifying 95 % of cases and controls. Excluding pericapsular soft tissue thickening, sequential assessment of 2nd toe enthesitis, 2nd flexor tendon subluxation, and splaying of the second and third toes accurately classified PP status in 92 %.Conclusions: Pericapsular soft tissue thickening most strongly correlated with PP tear. For cases in which it might be difficult to distinguish pericapsular fibrosis from neuroma, sequential assessment of 2nd toe enthesitis, flexor tendon subluxation and splaying of the 2nd and 3rd toe is most helpful for optimizing accurate diagnosis of PP tear. pubtype: Academic Journal doctype: Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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