Surgeon Agreement on the Presence of Pathologic Anterior Instability on Shoulder Imaging Studies

被引：8

作者：

Beason, Austin M. ^{[1
,2
]}

Koehler, Ryan J. ^{[1
,3
]}

Sanders, Rosemary A. ^{[1
,3
]}

Rode, Brooke E. ^{[1
,3
]}

Menge, Travis J. ^{[1
,4
]}

McCullough, Kirk A. ^{[1
,5
]}

Glass, Natalie A. ^{[1
,6
]}

Hettrich, Carolyn M. ^{[1
,7
]}

Bollier, Matthew J. ^{[1
,6
]}

Wolf, Brian R. ^{[1
,6
]}

Spencer, Edwin E. ^{[1
,8
]}

Grant, John A. ^{[1
,9
]}

Bishop, Julie Y. ^{[1
,10
]}

Jones, Grant L. ^{[1
,10
]}

Barlow, Jonathan D. ^{[1
,10
]}

Baumgarten, Keith M. ^{[1
,11
]}

Kelly, John D. ^{[1
,12
]}

Sennett, Brian J. ^{[1
,12
]}

Zgonis, Milt ^{[1
,12
]}

Abboud, Joseph A. ^{[1
,13
]}

Namdari, Surena ^{[1
,13
]}

Allen, Christina ^{[1
,14
]}

Kuhn, John E. ^{[1
,3
]}

Sullivan, Jaron P. ^{[1
,3
]}

Wright, Rick W. ^{[1
,15
]}

Brophy, Robert H. ^{[1
,15
]}

Smith, Matthew V. ^{[1
,15
]}

Dunn, Warren R. ^{[1
,16
]}

Cox, Charles L. ^{[1
,3
]}

机构：

[1] Vanderbilt Univ, Med Ctr, Dept Orthopaed & Rehabil, Med Ctr East,South Tower,Suite 3200, Nashville, TN 37232 USA

[2] Southern Illinois Univ, Sch Med, Springfield, IL USA

[3] Vanderbilt Univ, Med Ctr, Nashville, TN USA

[4] SHMG Orthoped & Sports Med, Grand Rapids, MI USA

[5] Clin Kansas City, Orthopaed & Sports Med, Kansas City, KS USA

[6] Univ Iowa, Iowa City, IA USA

[7] Univ Kentucky, Lexington, KY USA

[8] Knoxville Orthoped Clin, Knoxville, TN USA

[9] Univ Michigan, Ann Arbor, MI 48109 USA

[10] Ohio State Univ, Columbus, OH 43210 USA

[11] Orthoped Inst, Sioux Falls, SD USA

[12] Univ Penn, Philadelphia, PA 19104 USA

[13] Rothman Inst, Philadelphia, PA USA

[14] UCSF Med Ctr, San Francisco, CA USA

[15] Washington Univ, St Louis, MO 63110 USA

[16] Fondren Orthoped Grp, Houston, TX USA

来源：

ORTHOPAEDIC JOURNAL OF SPORTS MEDICINE | 2019年 / 7卷 / 08期

关键词：

shoulder instability; MRI; radiographs; agreement; diagnosis; INTEROBSERVER AGREEMENT; CLASSIFICATION; DISLOCATION; MRI; TEARS;

D O I：

10.1177/2325967119862501

中图分类号：

R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学（修复外科学）];

学科分类号：

摘要：

Background: In the setting of anterior shoulder instability, it is important to assess the reliability of orthopaedic surgeons to diagnose pathologic characteristics on the 2 most common imaging modalities used in clinical practice: standard plain radiographs and magnetic resonance imaging (MRI). Purpose: To assess the intra- and interrater reliability of diagnosing pathologic characteristics associated with anterior shoulder instability using standard plain radiographs and MRI. Study Design: Cohort study (diagnosis); Level of evidence, 3. Methods: Patient charts at a single academic institution were reviewed for anterior shoulder instability injuries. The study included 40 sets of images (20 radiograph sets, 20 MRI series). The images, along with standardized evaluation forms, were distributed to 22 shoulder/sports medicine fellowship-trained orthopaedic surgeons over 2 points in time. Kappa values for inter- and intrarater reliability were calculated. Results: The overall response rate was 91 %. For shoulder radiographs, interrater agreement was fair to moderate for the presence of glenoid lesions (kappa = 0.49), estimate of glenoid lesion surface area (kappa = 0.59), presence of a Hill-Sachs lesion (kappa = 0.35), and estimate of Hill-Sachs surface area (K - 0.50). Intrarater agreement was moderate for radiographs (kappa = 0.48-0.57). For shoulder MRI, interrater agreement was fair to moderate for the presence of glenoid lesions (kappa = 0.44), glenoid lesion surface area (kappa = 0.35), Hill-Sachs lesion (kappa = 0.33), Hill-Sachs surface area (kappa = 0.28), humeral head edema (kappa = 0.41), and presence of a capsulolabral injury (kappa = 0.36). Fair agreement was found for specific type of capsulolabral injury (kappa = 0.21). Intrarater agreement for shoulder MRI was moderate for the presence of glenoid lesion (kappa = 0.59), presence of a Hill-Sachs lesion (kappa = 0.52), estimate of Hill-Sachs surface area (kappa = 0.50), humeral head edema (kappa = 0.51), and presence of a capsulolabral injury (kappa = 0.53), and agreement was substantial for glenoid lesion surface area (kappa = 0.63). Intrarater agreement was fair for determining the specific type of capsulolabral injury (kappa = 0.38). Conclusion: Fair to moderate agreement by surgeons was found when evaluating imaging studies for anterior shoulder instability. Agreement was similar for identifying pathologic characteristics on radiographs and MRI. There was a trend toward better agreement for the presence of glenoid-sided injury. The lowest agreement was observed for specific capsulolabral injuries.

引用

页数：7

共 14 条

[1] Intra- and inter-rater reliability of the detection of tears of the supraspinatus central tendon on MRI by shoulder surgeons [J].