Diagnostic Accuracy of Ultrasonography in the Detection of Subacromial Bursitis Using Magnetic Resonance Imaging as the Gold Standard

Diagnostic accuracy of ultrasound in diagnosis of rotator cuff injuries keeping MRI as gold standard.

Its strong concordance with MRI supports its use as a first-line diagnostic tool, particularly for full-thickness tears, and remains essential in equivocal cases or when detailed pre-operative assessment is required.

Comparative Evaluation of MRI and Ultrasonography for Temporomandibular Joint Pathologies with Emphasis on Bone Marrow Edema.

OBJECTIVES This retrospective diagnostic accuracy study compared magnetic resonance imaging and ultrasonography in 98 temporomandibular joints from 49 patients for evaluating disc position, disc configuration, joint effusion, condylar degenerative changes, and bone marrow edema. METHODS A total of 98 temporomandibular joints from 49 patients who underwent both modalities were retrospectively evaluated by two independent, blinded observers using established classification systems. All imaging was performed prior to the initiation of any specific TMJ treatment. Intra- and inter-observer agreement, the diagnostic accuracy of ultrasonography relative to the magnetic resonance imaging reference standard, diagnostic likelihood ratios, and associations between parameters were analysed statistically. RESULTS Intra- and inter-observer agreement was good to excellent for both modalities (Kappa 0.71-0.91, p < 0.05). Ultrasonography showed high sensitivity and specificity for disc displacement (94.4-97.4% and 61.5-70.0%) and effusion (87.5-92.3% and 84.0-87.0%), but more limited performance for bone marrow edema, particularly in specificity (60.0-61.1%). On the left side, magnetic resonance imaging identified bone marrow edema in 63.3% of cases compared with 36.7% on ultrasonography (p = 0.015). Folded and convex disc configurations and marked or severe effusion were both associated with displacement without reduction (p ≤ 0.046). CONCLUSIONS Ultrasonography appears suitable as a first-line screening modality for selected TMJ abnormalities, whereas magnetic resonance imaging remains indispensable whenever bone marrow pathology or complex internal derangement is suspected. ADVANCES IN KNOWLEDGE This study provides direct, same-patient diagnostic accuracy data comparing ultrasonography with magnetic resonance imaging across multiple temporomandibular joint pathologies, including an indirect ultrasonographic assessment of bone marrow edema via cortical irregularity, clarifying which findings ultrasonography can reliably screen for and which still require magnetic resonance imaging confirmation.

Comparison of Ultrasonographic and Radiographic Findings in Knee Osteoarthritis: A Cross-sectional Study

USG provides improved detection of osteophytes and offers additional information on soft-tissue and early structural changes in knee OA and serves as a valuable, accessible adjunct to conventional radiography for comprehensive evaluation and early diagnosis of knee OA.

The Accuracy of Different Modalities in the Diagnosis of Oral Intraosseous Lesions in Comparison to Histopathological Findings

Objective: The study aimed to compare the diagnostic accuracy of different imaging modalities for detecting intraosseous jaw lesions, using histopathological diagnosis as the reference standard, and to assess interobserver agreement in response to initial radiographic reports. Methods: A total of 108 patients diagnosed with intraosseous jaw lesions were included. Radiographic images (Cone Beam Computed Tomography, Computed Tomography, and Orthopantomography) and reports with the related histopathological diagnosis were collected. Two radiologists, blinded to the histopathological results, reviewed the images using a (semiquantitative) scoring system. Kappa coefficients were calculated to evaluate interobserver agreement. Results: The majority of lesions were radiolucent (79.6%), with cystic lesions (50.0%) being the most common, particularly radicular cysts (24.1%). Well-defined borders were predominant (62.0%). Most lesions were related to the inferior alveolar canal (IAC) (20.4%), followed by the maxillary sinus (11.1%). Both observers showed substantial agreement in response to the extension of the lesions and relation to the tooth (0.701 and 0.660, respectively). CBCT showed the highest diagnostic accuracy between the two observers in detecting score 3 of the differential diagnosis (81.8%), which represents a correct first-ranked differential diagnosis corresponding to the histopathological findings. Conclusions: CBCT has the best accuracy in the diagnosis of intraosseous jaw lesions, particularly for lesions' density, anatomical extension, and relation to the tooth. Still, certain radiographic interpretation parameters showed non-agreement between observers. Evidence-based diagnosis and treatment planning require standardized reporting and proper interobserver training.

Diagnostic value of clinical signs for detecting temporomandibular joint disc displacement: a single-center cross-sectional diagnostic accuracy study using magnetic resonance imaging as the reference standard.

Diagnostic accuracy of doppler twinkling artifact in diagnosing smaller than 5 mm urolithiasis

Background: The Doppler twinkling effect has also become a promising adjunctive method to improve the ultrasound image of small urinary stones. The aim of the current research was to determine the diagnostic accuracy of the Doppler twinkling artifact in detecting urolithiasis with a diameter less than 5mm using non-contrast computed tomography of the kidneys, ureters, and bladder (CT-KUB) as the reference standard. Methods: This cross-sectional validation study carried out at the Department of Radiology, Indus hospital and health network, Karachi, between the months of August 2025 and March 2026. The sample comprised 134 patients aged between 20 and 80 years old and whose chief complaint was acute flank pain, which was followed by sequential grayscale and color Doppler ultrasonography, then non-contrast CT-KUB. The twinkling artifact in the Doppler imaging was noted and its diagnostic capability evaluated. All the essential diagnostic accuracy parameters were evaluated and stratified analysis was done on the basis of age, gender and duration of onset of symptoms. Results: Study was male dominant with 62.7% of male population and mean age of the total study population was 50.4±18.46 years. Urolithiasis was positive in 38.1% of enrolled subjects on non-contrast CT. Doppler twinkling artifact demonstrated a sensitivity of 86.3%, specificity of 92.8%, PPV of 88.0%, NPV of 91.7%, and overall diagnostic accuracy of 90.3%. The accuracy of the diagnosis had been found to be consistent across gender, age groups, and symptom duration with the overall accuracy ranging between 87.5% and 93.0%. Conclusion: The Doppler twinkling artifact is a noninvasive, radiation-free, reliable imaging adjunct, which has high diagnostic accuracy in detecting urolithiasis less than 5mm. Its systemic integration with ultrasound assessments would make it less reliant on computed tomography particularly in resource-limited contexts.