Diagnostic and Interventional Radiology
Pediatric Radiology - Original Article

Value of shoulder ultrasound compared to magnetic resonance imaging in infants with obstetric brachial plexus paralysis

1.

Department of Radiology, University of Health Sciences, Ankara Child Health and Diseases Hematology Oncology Training and Research Hospital, Ankara, Turkey

2.

Department of Radiology, Hacettepe University Faculty of Medicine, Ankara, Turkey

3.

Department of Orthopedics and Traumatology, Hacettepe University Faculty of Medicine, Ankara, Turkey

Diagn Interv Radiol 2020; 1: -
Read: 364 Published: 22 May 2020

PURPOSE: Children with brachial plexus birth injury (BPBI) may eventually develop glenohumeral instability due to development of unbalanced muscular strength. Our major goal in this study is to compare accuracy of physical examination and ultrasound in infants with BPBI in determination of glenohumeral instability compared to magnetic resonance imaging (MRI) as a gold standard and to investigate the role and value of ultrasound as a screening modality for assessing glenohumeral instability.

METHODS: Forty-two consecutive patients (mean age = 2.3 ± 0.8 months) with BPBI were enrolled into this prospective study. Patients were followed up with physical examination and ultrasound with dynamic evaluation in 4–6 weeks intervals. Patients who developed glenohumeral instability depending on physical examination and/or ultrasound (n = 21) underwent MRI. Glenohumeral instability was defined as if alpha angle > 30° and percentage of posterior humeral head displacement > 50%. Diagnostic accuracy of physical examination and ultrasound was calculated and quantitative parameters were compared with Wilcoxon test.

RESULTS: Glenohumeral instability was confirmed with MRI in 15 of 21 patients. Accuracy and sensitivity of physical examination and ultrasound were 47%, 66% and 100%, 100%, respectively in determination of glenohumeral instability. There was no significant difference was found for the alpha angle (P = 0.173) but for the percentage of posterior humeral head displacement (P = 0.028) between ultrasound and MRI.

CONCLUSION: Our results indicate that ultrasound with dynamic evaluation is a good alternative for MRI in assessment of glenohumeral instability in infants with BPBI, since it is highly accurate and specific and quantitative measurements used for glenohumeral instability were comparable to MRI. Ultrasound can be used as a screening method to assess glenohumeral instability in infants with BPBI.

 

EISSN 1305-3612