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. 2024 Jun;27(2):169-175.
doi: 10.5397/cise.2023.00836. Epub 2024 Mar 22.

Rate of incidental findings on routine preoperative computed tomography for shoulder arthroplasty

Daniel G Meeker  1 , Maria F Bozoghlian  1 , Taylor Den Hartog  1 , Jill Corlette  1 , James V Nepola  1 , Brendan M Patterson  1
Affiliations

Rate of incidental findings on routine preoperative computed tomography for shoulder arthroplasty

Daniel G Meeker et al. Clin Shoulder Elb. 2024 Jun.

Abstract

Background: Incidental findings are commonly noted in advanced imaging studies. Few data exist regarding the rate of incidental findings on computed tomography (CT) for preoperative shoulder arthroplasty planning. This study aims to identify the incidence of these findings and the rate at which they warrant further work-up to help guide orthopedic surgeons in counseling patients.

Methods: A retrospective review was performed to identify patients with available preoperative shoulder CT who subsequently underwent shoulder arthroplasty procedures at a single institution between 2015 and 2021. Data including age, sex, and smoking status were obtained. Radiology reports for CTs were reviewed for incidental findings and categorized based on location, tissue type, and/or body system. The rate of incidental findings and the rate at which further follow-up was recommended by the radiologist were determined.

Results: A total of 617 patients was identified. There were 173 incidental findings noted in 146 of these patients (23.7%). Findings ranged from pulmonary (59%), skin/soft tissue (16%), thyroid (13%), vascular (9%), spinal (2%), and abdominal (1%) areas. Of the pulmonary findings, 50% were pulmonary nodules and 47% were granulomatous disease. Overall, the final radiology report recommended further follow-up for 50% of the patients with incidental findings.

Conclusions: Incidental findings are relatively common in preoperative CTs obtained for shoulder arthroplasty, occurring in nearly one-quarter of patients. Most of these findings are pulmonary in nature. Overall, half of the patients with incidental findings were recommended for further follow-up. These results establish population data to guide orthopedic surgeons in patient counseling. Level of evidence: III.

Keywords: Arthroplasty; Incidental findings; Pulmonary nodule; Radiology; Shoulder.

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Conflict of interest statement

Conflict of interest

BMP has the following financial disclosures listed in the Funding section. No other potential conflicts of interest relevant to this article were reported.

Figures

Fig. 1.
Fig. 1.
Cohort selection. CPT: current procedural terminology, CT: computed tomography.
Fig. 2.
Fig. 2.
Proportion of incidental findings by location.
Fig. 3.
Fig. 3.
Types of pulmonary findings.
Fig. 4.
Fig. 4.
Need for follow-up by incidental image type.
See this image and copyright information in PMC

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