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Related Experiment Videos

Refuting the lipstick sign.

Jason A Grassbaugh1, Betsey R Bean2, Alyssa R Greenhouse3

  • 1Madigan Army Medical Center, Tacoma, WA, USA.

Journal of Shoulder and Elbow Surgery
|April 1, 2017
PubMed
Summary
This summary is machine-generated.

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The "lipstick sign" during arthroscopy has moderate accuracy for diagnosing long head of the biceps (LHB) tendinitis. Clinical diagnosis remains crucial before surgical evaluation for LHB tendinitis.

Area of Science:

  • Orthopedic Surgery
  • Sports Medicine
  • Diagnostic Imaging

Background:

  • Arthroscopic examination is the gold standard for diagnosing long head of the biceps (LHB) tendinitis.
  • The "lipstick sign" refers to an inflamed and hyperemic LHB within the bicipital groove during arthroscopy.
  • Limited studies have evaluated the diagnostic accuracy of direct arthroscopic visualization for LHB tendinitis.

Purpose of the Study:

  • To evaluate the sensitivity and specificity of the "lipstick sign" for diagnosing LHB tendinitis.
  • To assess interobserver and intraobserver reliability in arthroscopic diagnosis of LHB tendinitis.

Main Methods:

  • Prospective study of 363 arthroscopic shoulder procedures over 1 year.
  • 16 positive cases and 39 negative controls were selected based on clinical findings and ultrasound.
Keywords:
Lipstickarthroscopicbicipitalevaluationsigntendinopathy

Related Experiment Videos

  • Six surgeons reviewed randomized arthroscopic images to identify LHB tendinitis and the "lipstick sign".

    • Main Results:

    • Sensitivity and specificity for detecting LHB tendinitis were 49% and 66%, respectively.
    • Sensitivity and specificity for detecting erythema were 64% and 31%, respectively.
    • Interobserver reliability (κ score) for tendinitis was fair (mean 0.215), while intraobserver reliability was moderate (mean 0.615).

    Conclusions:

    • The "lipstick sign" demonstrated only moderate performance in diagnosing LHB tendinitis.
    • Fair agreement among surgeons highlights challenges in arthroscopic diagnosis.
    • Clinical diagnosis of LHB tendinitis should precede arthroscopic examination.