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AAPM 2025 - 67th Annual Meeting & Exhibition of the American Association of Physicists in Medicine

Evaluating Rotator Cuff Tears by Ultrasound Combined with Preoperative MRI Is Cost Effective

By MedImaging International staff writers
Posted on 08 Jun 2011

While ultrasound is typically seen as more cost-effective, magnetic resonance imaging (MRI) is most frequently used to evaluate the rotator cuff. When performing a cost utility analysis, utilizing ultrasound as the initial imaging test for rotator cuff tear, along with preoperative MRI to identify alternative and concurrent diagnoses, can be a very effective hybrid imaging strategy, according to recent research.

The study's findings were presented May 2011 at the 2011 American Roentgen Ray Society's annual meeting in Chicago (IL, USA). The study performed at Duke University Medical Center (Durham, NC, USA) and Rush University Medical Center (Chicago, IL, USA) utilized three evaluation techniques: the use of ultrasound alone, MRI alone, and a hybrid strategy of ultrasound for all patients followed by MRI for those patients who required surgery.

"Several meta-analyses in the literature have found that ultrasound and MRI have similar accuracies for the evaluation of rotator cuff tears. Ultrasound is a cheaper imaging modality, yet MRI is much more frequently used for rotator cuff evaluation," said Robert Lee Suber, MD, lead author of the study. "The reasons for the preference of MRI may be related to the possibility of identifying alternative and/or concurrent diagnoses with MRI as well as surgeon preference for anatomic imaging prior to surgery," said Dr. Suber.

According to Dr. Suber, one of the imaging approaches he and his colleagues assessed was an initial screening test with ultrasound. All those patients who required surgery or failed conservative treatment would then have an MRI. The investigators found this to be more cost effective than the cost of everyone undergoing MRI as the initial assessment. There are cutoff values for accuracy of ultrasound and/or MRI where this combined imaging application is no longer cost effective over MRI alone. Furthermore, as the prevalence (pre-test probability) for rotator cuff tear increases, this combined imaging strategy decreases in cost savings over MRI alone, Dr. Suber reported.

"Our research shows that in populations with a lower pre-test probability of rotator cuff tear [e.g., patients seeing family practice physicians as opposed to a shoulder specialist surgeon] it may be more cost effective to initially to obtain an ultrasound. Then if the patient needs to have surgery, they can get an MRI," Dr. Suber concluded.

Related Links:
Duke University Medical Center
Rush University Medical Center

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64 (54.836273193359): select jos_twitters.link from jos_twitters where cat=10

65 (28.848648071289): select jos_facebook.link from jos_facebook where cat=10

66 (31.948089599609): select jos_google_plus.link from jos_google_plus where cat=10

67 (29.087066650391): select jos_linkedin.link from jos_linkedin where cat=10

68 (30.994415283203): SELECT fid FROM jos_deeppockets WHERE id=294735477 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294735477 AND published='1' LIMIT 1

69 (41.007995605469): SELECT id,name,sponsor_text FROM jos_deeppockets dp left outer join jos_channel_sponsor cs on dp.id=cs.fid WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id=212 ORDER BY `ordering`

70 (276.80397033691): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294735477 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

71 (217.19932556152): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294735477 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

72 (38.14697265625): SELECT id,name,title FROM jos_deeppockets WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id != 294743300 AND id != 294743301 AND id != 294743302 AND id != 294743303 AND id != 294743304 AND id != 294743305 AND id != 294743306 AND id != 294743307 AND id != 294743308 AND id != 294743309 AND id != 294743310 AND metakey != 'aacc' ORDER BY `ordering`

73 (51.975250244141): SELECT show_live FROM jos_com_show_setting LIMIT 1

74 (30.040740966797): SELECT show_live FROM jos_com_show_setting LIMIT 1

75 (25.98762512207): SELECT show_live FROM jos_com_show_setting LIMIT 1

76 (25.98762512207): SELECT show_live FROM jos_com_show_setting LIMIT 1

77 (25.98762512207): SELECT show_live FROM jos_com_show_setting LIMIT 1

78 (25.98762512207): SELECT show_live FROM jos_com_show_setting LIMIT 1

79 (25.033950805664): SELECT show_live FROM jos_com_show_setting LIMIT 1

80 (25.033950805664): SELECT show_live FROM jos_com_show_setting LIMIT 1

81 (35.04753112793): SELECT show_live FROM jos_com_show_setting LIMIT 1

82 (30.994415283203): SELECT show_live FROM jos_com_show_setting LIMIT 1

83 (30.040740966797): SELECT show_live FROM jos_com_show_setting LIMIT 1

84 (30.994415283203): SELECT show_live FROM jos_com_show_setting LIMIT 1

85 (66.041946411133): SELECT show_live FROM jos_com_show_setting LIMIT 1

86 (47.922134399414): SELECT show_live FROM jos_com_show_setting LIMIT 1

87 (61.03515625): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294735477 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

88 (32.901763916016): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294735477 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

89 (36.954879760742): SELECT id,name,title FROM jos_deeppockets WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id != 294743300 AND id != 294743301 AND id != 294743302 AND id != 294743303 AND id != 294743304 AND id != 294743305 AND id != 294743306 AND id != 294743307 AND id != 294743308 AND id != 294743309 AND id != 294743310 AND metakey != 'aacc' ORDER BY `ordering`

90 (47.922134399414): SELECT show_live FROM jos_com_show_setting LIMIT 1

91 (30.040740966797): SELECT show_live FROM jos_com_show_setting LIMIT 1

92 (29.087066650391): SELECT show_live FROM jos_com_show_setting LIMIT 1

93 (37.908554077148): SELECT show_live FROM jos_com_show_setting LIMIT 1

94 (43.869018554688): SELECT show_live FROM jos_com_show_setting LIMIT 1

95 (40.054321289062): SELECT show_live FROM jos_com_show_setting LIMIT 1

96 (41.007995605469): SELECT show_live FROM jos_com_show_setting LIMIT 1

97 (37.908554077148): SELECT show_live FROM jos_com_show_setting LIMIT 1

98 (28.848648071289): SELECT show_live FROM jos_com_show_setting LIMIT 1

99 (28.848648071289): SELECT show_live FROM jos_com_show_setting LIMIT 1

100 (35.04753112793): SELECT show_live FROM jos_com_show_setting LIMIT 1

101 (34.093856811523): SELECT show_live FROM jos_com_show_setting LIMIT 1

102 (29.087066650391): SELECT show_live FROM jos_com_show_setting LIMIT 1

103 (28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1

104 (70.095062255859): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294735477 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294735477 AND published='1' LIMIT 1

105 (53.882598876953): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294735477 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294735477 AND published='1' LIMIT 1

106 (49.114227294922): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294735477 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

107 (46.968460083008): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294735477 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

108 (102.04315185547): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294735477 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294735477 AND published='1' LIMIT 1

109 (48.87580871582): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294735477 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294735477 AND published='1' LIMIT 1

110 (47.922134399414): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.id=294735477 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

111 (581.97975158691): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.id=294735477 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

112 (546.93222045898): SELECT dp.name, dp.id, dp2.name as channel, ex.name as author_name, ex.specialization, ex.images FROM jos_deeppockets as dp LEFT JOIN jos_experts as ex ON ex.id = dp.author LEFT JOIN jos_deeppockets as dp2 ON dp2.id = dp.fid WHERE dp.author != 0 AND dp.cat = 10 AND dp.published = 1 AND ( (dp.fid = 294743300) OR (dp.fid = 294743301) OR (dp.fid = 294743302) OR (dp.fid = 294743303) OR (dp.fid = 294743304) OR (dp.fid = 294743305) OR (dp.fid = 294743306) OR (dp.fid = 294743307) OR (dp.fid = 294743308) OR (dp.fid = 294743309) OR (dp.fid = 294743310) ) ORDER BY RAND() LIMIT 1

113 (496.86431884766): SELECT dp.name, dp.id, dp2.name as channel, ex.name as author_name, ex.specialization, ex.images FROM jos_deeppockets as dp LEFT JOIN jos_experts as ex ON ex.id = dp.author LEFT JOIN jos_deeppockets as dp2 ON dp2.id = dp.fid WHERE dp.author != 0 AND dp.cat = 10 AND dp.published = 1 AND ( (dp.fid = 294743300) OR (dp.fid = 294743301) OR (dp.fid = 294743302) OR (dp.fid = 294743303) OR (dp.fid = 294743304) OR (dp.fid = 294743305) OR (dp.fid = 294743306) OR (dp.fid = 294743307) OR (dp.fid = 294743308) OR (dp.fid = 294743309) OR (dp.fid = 294743310) ) ORDER BY RAND() LIMIT 1

114 (83.92333984375): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294735477 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294735477 AND published='1' LIMIT 1

115 (56.982040405273): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294735477 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294735477 AND published='1' LIMIT 1

116 (46.968460083008): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294735477 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294735477 AND published='1' LIMIT 1

117 (36.954879760742): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294735477 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294735477 AND published='1' LIMIT 1

118 (44.107437133789): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294735477 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294735477 AND published='1' LIMIT 1

119 (83.92333984375): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294735477 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294735477 AND published='1' LIMIT 1

120 (41.961669921875): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294735477 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294735477 AND published='1' LIMIT 1

121 (38.14697265625): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294735477 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294735477 AND published='1' LIMIT 1

122 (274.8966217041): SELECT * FROM trending_articles WHERE `journal_id` = 10 AND `timestamp` <= NOW() + INTERVAL 7 DAY ORDER BY `order`

123 (!!!!! 20617.008209229): SELECT * FROM jos_deeppockets WHERE jos_deeppockets.cat = 10 AND jos_deeppockets.type = 'deeppockets_item' AND jos_deeppockets.published = 1 AND jos_deeppockets.created + INTERVAL 14 DAY >= NOW() ORDER BY jos_deeppockets.hits DESC LIMIT 7

124 (466.10832214355): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294735477 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294735477 AND type='deeppockets_item' AND published='1' LIMIT 1

125 (!!!!! 7277.9655456543): ( SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.video != '' AND dp.video_source != '' AND dp.cat = 10 AND dp.published = 1 AND dp.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) UNION ( SELECT dpa.id, dpa.name, dpa.title, dpa.video, dpa.video_source, dpa.created FROM jos_deeppockets_archive AS dpa WHERE dpa.video != '' AND dpa.video_source != '' AND dpa.cat = 10 AND dpa.published = 1 AND dpa.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) ORDER BY created DESC LIMIT 3

126 (77.962875366211): ( SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.video != '' AND dp.video_source != '' AND dp.cat = 10 AND dp.published = 1 AND dp.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) UNION ( SELECT dpa.id, dpa.name, dpa.title, dpa.video, dpa.video_source, dpa.created FROM jos_deeppockets_archive AS dpa WHERE dpa.video != '' AND dpa.video_source != '' AND dpa.cat = 10 AND dpa.published = 1 AND dpa.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) ORDER BY created DESC LIMIT 3

127 (292.06275939941): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294803337 LIMIT 1

128 (68.902969360352): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294803337 LIMIT 1

129 (236.98806762695): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294803276 LIMIT 1

130 (36.954879760742): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294803276 LIMIT 1

131 (180.95970153809): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets_archive AS dp WHERE dp.id = 294803276 LIMIT 1

132 (47.922134399414): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets_archive AS dp WHERE dp.id = 294803276 LIMIT 1

133 (202.17895507812): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294802958 LIMIT 1

134 (51.975250244141): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294802958 LIMIT 1

135 (828.02772521973): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294735477 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

136 (814.91470336914): SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294735477 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

137 (465.86990356445): SELECT name FROM jos_deeppockets WHERE id=212

138 (71.048736572266): SELECT name FROM jos_deeppockets WHERE id=212

139 (!!!!! 1245.0218200684): SELECT *, DATE_FORMAT(publish_up,'%d %b %Y') AS date_publish_up, DATE_FORMAT(publish_down,'%d %b %Y') AS date_publish_down FROM jos_events WHERE state=1 AND publish_up > NOW() and extra_info REGEXP '((;)|(^))212((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

140 (!!!!! 1126.0509490967): SELECT *, DATE_FORMAT(publish_up,'%d %b %Y') AS date_publish_up, DATE_FORMAT(publish_down,'%d %b %Y') AS date_publish_down FROM jos_events WHERE state=1 AND publish_up > NOW() and extra_info REGEXP '((;)|(^))212((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

141 (174.99923706055): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294735477 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294735477 AND published='1' LIMIT 1

142 (116.82510375977): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294735477 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294735477 AND published='1' LIMIT 1

143 (!!!!! 13442.993164062): TRUNCATE TABLE jos_trademed_module

144 (208.13941955566): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294735477 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

145 (115.15617370605): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294735477 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

146 (787.01972961426): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294735477 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

147 (112.05673217773): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294735477 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

148 (145.91217041016): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294735477 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294735477 AND published='1' LIMIT 1

149 (102.04315185547): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294735477 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294735477 AND published='1' LIMIT 1

150 (!!!!! 2402.0671844482): SELECT jos_item.* FROM jos_item INNER JOIN jos_number ON jos_item.numberID=jos_number.id WHERE 1=1 AND (jos_item.imgMini<>'') AND jos_item.type='L' AND jos_item.numberID= ( SELECT jos_number.id FROM jos_number WHERE jos_number.journalID IN (10) and jos_number.id in (select distinct jos_number.id from jos_number join jos_item on jos_item.numberid=jos_number.id where jos_item.type='P') ORDER BY (CONVERT(SUBSTRING(issue,1,2),SIGNED) + (CONVERT(SUBSTRING(issue,3,2),SIGNED)*100)) DESC LIMIT 0,1 ) ORDER BY RAND() DESC LIMIT 6

151 (150.91896057129): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294735477 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294735477 AND published='1' LIMIT 1

152 (106.8115234375): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294735477 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294735477 AND published='1' LIMIT 1

153 (87.976455688477): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294735477 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294735477 AND type='deeppockets_item' AND published='1' LIMIT 1

154 (64.13459777832): select distinct links.* from jos_textlinks links join jos_textlinks_placement placement on links.id=placement.link_id where journal_id=(10) and (channel_id=212 or channel_id is null)

155 (63.180923461914): select distinct links.* from jos_textlinks links join jos_textlinks_placement placement on links.id=placement.link_id where journal_id=(10) and (channel_id=212 or channel_id is null)

156 (66.041946411133): SELECT livesite FROM jos_dp_categories WHERE id=10 AND published='1' LIMIT 1

157 (121.8318939209): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294735477 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294735477 AND published='1' LIMIT 1

158 (80.82389831543): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294735477 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294735477 AND published='1' LIMIT 1

159 (194.07272338867): select jos_twitters.link from jos_twitters where cat=10

160 (61.988830566406): select jos_facebook.link from jos_facebook where cat=10

161 (61.03515625): select jos_google_plus.link from jos_google_plus where cat=10

162 (61.03515625): select jos_linkedin.link from jos_linkedin where cat=10

163 (519.99092102051): update jos_bannersmanager_banner set impmade=impmade+1 where id in(14615,14202,14203)

164 (!!!!! 1638.8893127441): insert into jos_banners_delta values (14615,'2025-06-27 06:12:19','216.73.216.249','view'),(14202,'2025-06-27 06:12:19','216.73.216.249','view'),(14203,'2025-06-27 06:12:19','216.73.216.249','view')

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