Accuracy and Reliability of Imaging Modalities for the Diagnosis and Quantification of Hill-Sachs Lesions: A Systematic Review

PurposeTo determine the reliability and accuracy of different imaging modalities in assessing Hill-Sachs lesions within setting anterior shoulder instability.MethodsA systematic review was performed according to PRISMA (Preferred Reporting Items for Systematic Reviews Meta-analyses) guidelines using PubMed, Scopus, Embase, Cochrane Library databases. The inclusion criteria were clinical trials or cadaveric studies that assessed humeral head bone loss English-language articles. exclusion animal studies; without measures accuracy, reliability, predictive power; injuries loss; editorials; abstracts; reviews; case reports; surveys. search terms included “imaging” OR “radiographic” “CT” “MRI” AND “Hill-Sachs” “humeral loss.” Assessment methodologic quality original Quality Diagnostic Accuracy Studies (QUADAS) tool.ResultsForty (2,560 shoulders) met assessed. For diagnosing presence lesions, computed tomography (CT) arthrography had highest reported (median, 91%; range, 66%-100%). same assessment, CT also greatest sensitivity 94%; 50%-100%). quantification lesion parameters, intraobserver reliabilities 3-dimensional (3D) (intraclass correlation coefficient [ICC] 0.916-0.999), followed by 2-dimensional (ICC 0.858-0.861) magnetic resonance (MRI) 0.28-0.97). interobserver 3D 0.772-0.996), 0.721-0.879), MRI (κ 0.444-0.700). Intraobserver determining glenoid tracking only 0.730-1.00; ICC 0.803-0.901) 0.770-0.790).ConclusionsThis study shows current literature supports a variety provide clinically acceptable quantifying as well whether they will cause persistent instability. Furthermore, this justifies further research is needed help develop treatment algorithm on proper treat patients with instability both reliable financially acceptable.Level EvidenceLevel IV, Level I through IV studies. To A tool. Forty 0.770-0.790). This acceptable.