Asociación entre el signo de abril y la ruptura proximal de la cabeza larga del bíceps confirmada por resonancia magnética en pacientes atendidos en consulta externa de miembro superior

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dc.contributor.advisorAbril Gaona, Cesar Augusto
dc.contributor.apolounabAbril Gaona, Cesar Augusto [cesar-augusto-abril-gaona]spa
dc.contributor.authorSánchez Rodríguez, Daniel Fernando
dc.contributor.cvlacAbril Gaona, Cesar Augusto [0001767981]spa
dc.contributor.orcidAbril Gaona, Cesar Augusto [0000-0002-8092-4128]spa
dc.contributor.researchgroupSemilleros de Investigación UNABspa
dc.coverage.campusUNAB Campus Bucaramangaspa
dc.coverage.spatialFloridablanca (Santander, Colombia)spa
dc.coverage.temporalJunio de 2021 a noviembre de 2024.spa
dc.date.accessioned2025-01-30T21:53:38Z
dc.date.available2025-01-30T21:53:38Z
dc.date.issued2025-01-29
dc.degree.nameEspecialista en Ortopedia y Traumatologíaspa
dc.description.abstractIntroducción El dolor de hombro afecta hasta el 67% de la población. La ruptura proximal del tendón largo del bíceps es una causa frecuente, cuyo diagnóstico se ve limitado por la disponibilidad de resonancia magnética. Este estudio evalúa la precisión del "Signo de Abril" como herramienta diagnóstica no invasiva y su relación con variables clínicas, demográficas y antropométricas. Metodología Estudio de casos y controles en 184 pacientes con diagnóstico clínico y confirmación por resonancia magnética. Los casos fueron pacientes con ruptura completa del tendón largo del bíceps. Se evaluaron el Signo de Abril, sensibilidad (S), especificidad (E), valor predictivo positivo (VPP) y negativo (VPN). Variables demográficas y clínicas se analizaron mediante pruebas t y chi-cuadrado, mientras que la relación entre la resonancia magnética y el Signo de Abril se evaluó usando un modelo de regresión binomial. Resultados La edad promedio fue mayor en los casos (64.76 años) que en los controles (58.45 años, p=0.011). Los hombres tuvieron mayor frecuencia de rupturas completas (62.07% en casos vs. 41.94% en controles, p=0.046). No hubo diferencias significativas en el IMC (25.86 vs. 25.32, p=0.3). El dolor (EVA) fue más intenso en los casos (7.59 vs. 7.01, p=0.036), y la capsulitis adhesiva (31.03% vs. 9.03%, p=0.003) y el síndrome del manguito rotador (44.83% vs. 20.65%, p=0.005) fueron más prevalentes. El Signo de Abril tuvo S=89.66%, E=94.19%, VPP=74.29% y VPN=97.99%, con una exactitud de 93.48% (kappa=0.7734). El coeficiente estimado para la resonancia fue de 4.945, lo que indica que por cada incremento unitario en el resultado de la resonancia, la probabilidad de un Signo de Abril positivo aumenta en un factor de 4.94 (p<0.001). Conclusiones El Signo de Abril se correlaciona fuertemente con los resultados positivos en la resonancia magnética, con un coeficiente de 4.945 que respalda su utilidad como herramienta predictiva. Además, variables como la edad avanzada, el sexo masculino, dolor intenso, capsulitis adhesiva y el síndrome del manguito rotador se asocian con mayor probabilidad de rupturas completas. El Signo de Abril es una alternativa diagnóstica precisa y accesible en contextos con recursos limitados.spa
dc.description.abstractenglishIntroduction Shoulder pain affects up to 67% of the population. Proximal rupture of the long head of the biceps tendon is a common cause, but its diagnosis is often limited by the availability of magnetic resonance imaging (MRI). This study evaluates the accuracy of the "April Sign" as a non-invasive diagnostic tool and its relationship with clinical, demographic, and anthropometric variables. Methodology A case-control study was conducted with 184 patients diagnosed clinically and confirmed by MRI. Cases included patients with a complete rupture of the long head of the biceps tendon. The "April Sign" was assessed along with sensitivity (S), specificity (E), positive predictive value (PPV), and negative predictive value (NPV). Demographic and clinical variables were analyzed using t-tests and chi-square tests, while the relationship between MRI findings and the "April Sign" was evaluated using a binomial regression model. Results The average age was higher in cases (64.76 years) than in controls (58.45 years, p=0.011). Males had a higher frequency of complete ruptures (62.07% in cases vs. 41.94% in controls, p=0.046). No significant differences were found in BMI (25.86 vs. 25.32, p=0.3). Pain intensity (VAS) was higher in cases (7.59 vs. 7.01, p=0.036), and adhesive capsulitis (31.03% vs. 9.03%, p=0.003) and rotator cuff syndrome (44.83% vs. 20.65%, p=0.005) were more prevalent. The "April Sign" showed S=89.66%, E=94.19%, PPV=74.29%, and NPV=97.99%, with an accuracy of 93.48% (kappa=0.7734). The estimated coefficient for MRI findings was 4.945, indicating that for each unit increase in MRI results, the probability of a positive "April Sign" increased by a factor of 4.94 (p<0.001). Conclusions The "April Sign" strongly correlates with positive MRI findings, with a coefficient of 4.945 supporting its use as a predictive tool. Additionally, advanced age, male sex, severe pain, adhesive capsulitis, and rotator cuff syndrome are associated with a higher likelihood of complete ruptures. The "April Sign" is a precise and accessible diagnostic alternative in resource-limited settings.spa
dc.description.degreelevelEspecializaciónspa
dc.description.learningmodalityModalidad Presencialspa
dc.description.tableofcontentsRESUMEN 3 1. JUSTIFICACIÓN 4 2. MARCO TEÓRICO 6 3. ESTADO DEL ARTE 12 4. OBJETIVOS 17 4.1 Objetivo General 17 5. HIPÓTESIS 17 6. METODOLOGÍA 18 6.1 Diseño de estudio 18 6.2 Población y muestra 18 6.3 Criterios de selección (inclusión y exclusión) 18 6.4 Selección de casos y controles 18 6.5 Recolección de datos 19 6.5 Variables 19 6.6 Análisis estadístico 21 6.7 Consideraciones éticas 22 7. RESULTADOS ESPERADOS 23 1. Relacionados con la generación de nuevo conocimiento 23 2. Conducentes al fortalecimiento de la capacidad científica institucional 24 3. Impactos esperados 24 8. CRONOGRAMA DE ACTIVIDADES 25 9. PRESUPUESTO 25 10. RESULTADOS 28 11. DISCUSIÓN 32 12. CONCLUSIÓN 33 13. BIBLIOGRAFÍA 34spa
dc.format.mimetypeapplication/pdfspa
dc.identifier.instnameinstname:Universidad Autónoma de Bucaramanga - UNABspa
dc.identifier.reponamereponame:Repositorio Institucional UNABspa
dc.identifier.repourlrepourl:https://repository.unab.edu.cospa
dc.identifier.urihttp://hdl.handle.net/20.500.12749/27941
dc.language.isospaspa
dc.publisher.facultyFacultad Ciencias de la Saludspa
dc.publisher.grantorUniversidad Autónoma de Bucaramanga UNABspa
dc.publisher.programEspecialización en Ortopedia y Traumatologíaspa
dc.publisher.programidEOT-2177
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dc.relation.uriapolohttps://apolo.unab.edu.co/en/persons/cesar-augusto-abril-gaonaspa
dc.rights.accessrightsinfo:eu-repo/semantics/openAccessspa
dc.rights.creativecommonsAtribución-NoComercial-SinDerivadas 2.5 Colombia*
dc.rights.localAbierto (Texto Completo)spa
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/2.5/co/*
dc.subject.keywordsLong head of the bicepsspa
dc.subject.keywordsTendon injuryspa
dc.subject.keywordsPhysical examinationspa
dc.subject.keywordsDynamic biceps testspa
dc.subject.keywordsAmbulatory medical carespa
dc.subject.keywordsShoulder painspa
dc.subject.keywordsHealth sciencesspa
dc.subject.keywordsClinical medicinespa
dc.subject.keywordsMagnetic resonance imagingspa
dc.subject.keywordsDiagnostic imagingspa
dc.subject.lembCiencias médicasspa
dc.subject.lembAtención médica ambulatoriaspa
dc.subject.lembDolor de hombrospa
dc.subject.lembCiencias de la saludspa
dc.subject.lembMedicina clínicaspa
dc.subject.lembResonancia magnética en imágenesspa
dc.subject.lembDiagnóstico por imagenspa
dc.subject.proposalCabeza larga del bícepsspa
dc.subject.proposalLesión del tendónspa
dc.subject.proposalExamen físicospa
dc.subject.proposalPrueba dinámica del bícepsspa
dc.titleAsociación entre el signo de abril y la ruptura proximal de la cabeza larga del bíceps confirmada por resonancia magnética en pacientes atendidos en consulta externa de miembro superiorspa
dc.title.translatedAssociation Between the 'April Sign' and Proximal Rupture of the Long Head of the Biceps Confirmed by Magnetic Resonance Imaging in Patients Attending Upper Limb Outpatient Clinics.spa
dc.typeThesiseng
dc.type.coarhttp://purl.org/coar/resource_type/c_bdcc
dc.type.coarversionhttp://purl.org/coar/version/c_ab4af688f83e57aaspa
dc.type.driverinfo:eu-repo/semantics/masterThesisspa
dc.type.hasversioninfo:eu-repo/semantics/acceptedVersionspa
dc.type.localTesisspa
dc.type.redcolhttp://purl.org/redcol/resource_type/TMspa

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