目的:主要目的是确定无症状成人的盂肱关节成像异常的人群患病率。
方法:我们系统回顾了报告X线患病率的研究,超声(美国),计算机断层扫描(CT),和磁共振成像(MRI)异常成人无肩部症状(PROSPERO注册号CRD42018090041)。本报告介绍了盂肱关节的影像学发现。我们搜索了OvidMEDLINE,Embase,CINAHL和WebofScience从成立到2023年6月,并使用为患病率研究设计的工具评估偏倚风险。计划对一般人群进行初步分析。使用修改后的建议等级评估证据的确定性,评估,发展,和评估(等级)的预后研究。
结果:35项研究(4项X射线,10US,20MRI,1X射线和MRI)报告了可用的患病率数据。两项研究是基于人群的(846个肩膀),15项研究包括杂项研究人群(1715名肩膀)和18名运动员(727名肩膀)。所有的人都被判断为有很高的偏倚风险。临床多样性排除了合并。肱骨关节炎的人群患病率从15%到75%不等(2项研究,846路肩,1张X光片,1X射线和MRI;低确定性证据)。唇异常的患病率,肱骨头囊肿和长头肱二头肌肌腱异常占20%,5%,分别为30%(1项研究,20个肩膀,X射线和MRI;非常低的确定性证据)。
结论:无症状个体中基于人群的盂肱关节成像异常的患病率仍不确定,但可能在30%到75%之间。需要更好的估计来为肩痛患者提供最佳的循证管理。
OBJECTIVE: The primary objective was to determine the population prevalence of glenohumeral joint imaging abnormalities in asymptomatic adults.
METHODS: We systematically reviewed studies reporting the prevalence of X-ray, ultrasound (US), computed tomography, and magnetic resonance imaging (MRI) abnormalities in adults without shoulder symptoms (PROSPERO registration number CRD42018090041). This report presents the glenohumeral joint imaging findings. We searched Ovid MEDLINE, Embase, CINAHL and Web of Science from inception to June 2023 and assessed risk of bias using a tool designed for prevalence studies. The primary analysis was planned for the general population. The certainty of evidence was assessed using a modified Grades of Recommendation, Assessment, Development, and Evaluation (GRADE) for prognostic studies.
RESULTS: Thirty-five studies (4 X-ray, 10 US, 20 MRI, 1 X-ray and MRI) reported useable prevalence data. Two studies were population-based (846 shoulders), 15 studies included miscellaneous study populations (1715 shoulders) and 18 included athletes (727 shoulders). All were judged to be at high risk of bias. Clinical diversity precluded pooling. Population prevalence of glenohumeral osteoarthritis ranged from 15% to 75% (2 studies, 846 shoulders, 1 X-ray, 1 X-ray and MRI; low certainty evidence). Prevalence of labral abnormalities, humeral head cysts and long head of biceps tendon abnormalities were 20%, 5%, 30% respectively (1 study, 20 shoulders, X-ray and MRI; very low certainty evidence).
CONCLUSIONS: The population-based prevalence of glenohumeral joint imaging abnormalities in asymptomatic individuals remains uncertain, but may range between 30% and 75%. Better estimates are needed to inform best evidence-based management of people with shoulder pain.