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1رسالة جامعية
المؤلفون: Dalla-Torre, Romain
المساهمون: Nantes Université - UFR de Médecine et des Techniques Médicales (Nantes Univ - UFR MEDECINE), Nantes Université - pôle Santé, Nantes Université (Nantes Univ)-Nantes Université (Nantes Univ), Christelle Darrieutort-Laffite
المصدر: https://dumas.ccsd.cnrs.fr/dumas-03781873Test ; Médecine humaine et pathologie. 2022.
مصطلحات موضوعية: Coiffe des rotateurs de l'épaule, Ténopathies, Radiographie, Scores en médecine, Thèses et écrits académiques, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
الوصف: Background: Calcific tendinitis of the rotator cuff (CTRC) is one of the most common causes of shoulder pain, affecting 10 to 42% of patients referred for a painful shoulder. The diagnosis is usually confirmed by standard radiographs. Various radiographic classifications have been developed, but none of them is considered satisfactory to date. Among other things, they are criticized for their lack of inter-observer reproducibility and the absence of radio-clinical correlation. Purpose: The aim was to evaluate the metric properties of a new scoring system for CTRC, by testing its intra- and inter-reader reliability, sensitivity to change and correlation with the clinical outcomes after treatment. Methods: This is a post hoc analysis of the CALCECHO trial, a double-blinded randomizedcontrolled trial assessing the effect of corticosteroid injections after UGPL. All patients received an ultrasound-guided puncture and lavage (UGPL) of their rotator cuff calcification. From this database, 276 radiographs of 69 patients were analyzed at baseline, 7 days (D7), 3 months (M3) and 12 months (M12) after the UGPL using the classifications of Molé, Gärtner and our new Darrieutort-Laffite score. We also collected the patients' clinical data at baseline and during follow-up. Inter-observer and intra-observer reliability were established between three independent investigators (2 experts and one junior) by weighted kappa. Construct validity was assessed between pain, function and radiological stages. Predictive validity was assessed to predict clinical improvement after UGPL. Finally, sensitivity to change was assessed by standardized response mean (SRM). Results: In this 12-month follow-up study, the reliability of the proposed scoring system for calcific tendonitis was tested. We found a substantial inter-reader reliability with 0.677, 0.744 and 0.656 at D7, M3 and M12 respectively, higher than for Molé and Gärtner classifications. Intra-reader agreement was between 0.577 and 0.836 for the two expert readers and between 0.519 ...
العلاقة: dumas-03781873; https://dumas.ccsd.cnrs.fr/dumas-03781873Test; https://dumas.ccsd.cnrs.fr/dumas-03781873/documentTest; https://dumas.ccsd.cnrs.fr/dumas-03781873/file/Dalla-torreMED22.pdfTest; PPN: 264459008
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2رسالة جامعية
المؤلفون: Dalla-Torre, Romain
المساهمون: Nantes Université - UFR de Médecine et des Techniques Médicales (Nantes Univ - UFR MEDECINE), Nantes Université - pôle Santé, Nantes Université (Nantes Univ)-Nantes Université (Nantes Univ), Christelle Darrieutort-Laffite
المصدر: https://dumas.ccsd.cnrs.fr/dumas-03781873Test ; Médecine humaine et pathologie. 2022.
مصطلحات موضوعية: Coiffe des rotateurs de l'épaule, Ténopathies, Radiographie, Scores en médecine, Thèses et écrits académiques, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
الوصف: Background: Calcific tendinitis of the rotator cuff (CTRC) is one of the most common causes of shoulder pain, affecting 10 to 42% of patients referred for a painful shoulder. The diagnosis is usually confirmed by standard radiographs. Various radiographic classifications have been developed, but none of them is considered satisfactory to date. Among other things, they are criticized for their lack of inter-observer reproducibility and the absence of radio-clinical correlation. Purpose: The aim was to evaluate the metric properties of a new scoring system for CTRC, by testing its intra- and inter-reader reliability, sensitivity to change and correlation with the clinical outcomes after treatment. Methods: This is a post hoc analysis of the CALCECHO trial, a double-blinded randomizedcontrolled trial assessing the effect of corticosteroid injections after UGPL. All patients received an ultrasound-guided puncture and lavage (UGPL) of their rotator cuff calcification. From this database, 276 radiographs of 69 patients were analyzed at baseline, 7 days (D7), 3 months (M3) and 12 months (M12) after the UGPL using the classifications of Molé, Gärtner and our new Darrieutort-Laffite score. We also collected the patients' clinical data at baseline and during follow-up. Inter-observer and intra-observer reliability were established between three independent investigators (2 experts and one junior) by weighted kappa. Construct validity was assessed between pain, function and radiological stages. Predictive validity was assessed to predict clinical improvement after UGPL. Finally, sensitivity to change was assessed by standardized response mean (SRM). Results: In this 12-month follow-up study, the reliability of the proposed scoring system for calcific tendonitis was tested. We found a substantial inter-reader reliability with 0.677, 0.744 and 0.656 at D7, M3 and M12 respectively, higher than for Molé and Gärtner classifications. Intra-reader agreement was between 0.577 and 0.836 for the two expert readers and between 0.519 ...
العلاقة: dumas-03781873; https://dumas.ccsd.cnrs.fr/dumas-03781873Test; https://dumas.ccsd.cnrs.fr/dumas-03781873/documentTest; https://dumas.ccsd.cnrs.fr/dumas-03781873/file/Dalla-torreMED22.pdfTest; PPN: 264459008
