Can coronal STIR be used as screening for acute nontraumatic hip pain in children?

Monica M. Forbes-Amrhein, Megan B. Marine, Matthew Wanner, Trenton D. Roth, Joseph T. Davis, Ananth K. Ravi, Boaz Karmazyn

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

OBJECTIVE. The objective of this study is to evaluate whether coronal STIR MRI can be used as a screening test for nontraumatic acute hip pain in children. MATERIALS AND METHODS. From 2008 to 2012, we identified all patients younger than 18 years at our tertiary care facility who underwent pelvic MRI including coronal STIR for the following indications: acute hip pain, limping, or refusal to bear weight. Patients with a history of trauma were excluded. Each MR image was independently reviewed by four radiologists who were blinded to the clinical outcome. After first reviewing the coronal STIR images only, they then reviewed the full MRI studies in a random order different from that used for review of the coronal STIR images. The sensitivity and specificity of STIR-only images in identifying the presence of abnormality and specific diagnoses were calculated, with the full MRI study considered as the reference standard. Kappa values were calculated for STIRonly and full MRI studies. RESULTS. A total of 127 patients (67 female patients and 60 male patients; median age, 9 years; range, 5 months to 17 years) were identified. The most common abnormalities (calculated as the mean of frequency values noted by four readers) were hip effusion (52%; range, 46-58%), osteomyelitis (42%; range, 29-48%), and myositis (32%; range, 20-40%). For the detection of any abnormality, STIR-only images had a mean sensitivity of 95% and a mean specificity of 67%. For approximately one-third of STIR-only studies with true-positive results, additional abnormalities were found on full MRI studies. CONCLUSION. Coronal STIR imaging of the pelvis has high sensitivity (95%) in the detection of abnormalities associated with acute nontraumatic hip pain in children, but it often misses additional abnormalities.

Original languageEnglish (US)
Pages (from-to)676-683
Number of pages8
JournalAmerican Journal of Roentgenology
Volume209
Issue number3
DOIs
StatePublished - Sep 1 2017

Fingerprint

Hip
Pain
Acute Pain
Myositis
Osteomyelitis
Tertiary Healthcare
Pelvis
Weights and Measures
Sensitivity and Specificity
Wounds and Injuries

Keywords

  • Hip pain
  • Limited protocol
  • MRI
  • Pediatric
  • STIR

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

Forbes-Amrhein, M. M., Marine, M. B., Wanner, M., Roth, T. D., Davis, J. T., Ravi, A. K., & Karmazyn, B. (2017). Can coronal STIR be used as screening for acute nontraumatic hip pain in children? American Journal of Roentgenology, 209(3), 676-683. https://doi.org/10.2214/AJR.16.17685

Can coronal STIR be used as screening for acute nontraumatic hip pain in children? / Forbes-Amrhein, Monica M.; Marine, Megan B.; Wanner, Matthew; Roth, Trenton D.; Davis, Joseph T.; Ravi, Ananth K.; Karmazyn, Boaz.

In: American Journal of Roentgenology, Vol. 209, No. 3, 01.09.2017, p. 676-683.

Research output: Contribution to journalArticle

Forbes-Amrhein, MM, Marine, MB, Wanner, M, Roth, TD, Davis, JT, Ravi, AK & Karmazyn, B 2017, 'Can coronal STIR be used as screening for acute nontraumatic hip pain in children?', American Journal of Roentgenology, vol. 209, no. 3, pp. 676-683. https://doi.org/10.2214/AJR.16.17685
Forbes-Amrhein, Monica M. ; Marine, Megan B. ; Wanner, Matthew ; Roth, Trenton D. ; Davis, Joseph T. ; Ravi, Ananth K. ; Karmazyn, Boaz. / Can coronal STIR be used as screening for acute nontraumatic hip pain in children?. In: American Journal of Roentgenology. 2017 ; Vol. 209, No. 3. pp. 676-683.
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abstract = "OBJECTIVE. The objective of this study is to evaluate whether coronal STIR MRI can be used as a screening test for nontraumatic acute hip pain in children. MATERIALS AND METHODS. From 2008 to 2012, we identified all patients younger than 18 years at our tertiary care facility who underwent pelvic MRI including coronal STIR for the following indications: acute hip pain, limping, or refusal to bear weight. Patients with a history of trauma were excluded. Each MR image was independently reviewed by four radiologists who were blinded to the clinical outcome. After first reviewing the coronal STIR images only, they then reviewed the full MRI studies in a random order different from that used for review of the coronal STIR images. The sensitivity and specificity of STIR-only images in identifying the presence of abnormality and specific diagnoses were calculated, with the full MRI study considered as the reference standard. Kappa values were calculated for STIRonly and full MRI studies. RESULTS. A total of 127 patients (67 female patients and 60 male patients; median age, 9 years; range, 5 months to 17 years) were identified. The most common abnormalities (calculated as the mean of frequency values noted by four readers) were hip effusion (52{\%}; range, 46-58{\%}), osteomyelitis (42{\%}; range, 29-48{\%}), and myositis (32{\%}; range, 20-40{\%}). For the detection of any abnormality, STIR-only images had a mean sensitivity of 95{\%} and a mean specificity of 67{\%}. For approximately one-third of STIR-only studies with true-positive results, additional abnormalities were found on full MRI studies. CONCLUSION. Coronal STIR imaging of the pelvis has high sensitivity (95{\%}) in the detection of abnormalities associated with acute nontraumatic hip pain in children, but it often misses additional abnormalities.",
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AU - Ravi, Ananth K.

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