The reliability of the Risser sign is acceptable and can be further improved when other markers of skeletal maturity on the pelvis radiograph are used to assist in grading.

Background:The purpose of the study was to determine the inter-and intrarater reliability of the alpha angle measured on hip axial and axial oblique MRI, which has not been well defined in the existing orthopaedic literature. Methods:Fifty MRIs were reviewed by one musculoskeletal radiologist and two orthopaedic hip surgeons. The examiners evaluated the alpha angle measurements in two rounds. In each round, the three examiners independently reviewed all MRIs in random order to establish intrarater and interrater reliability. Correlation coefficients were calculated between pairs of alpha angle readings. Results:The pooled intrarater reliability when testing all 50 MRIs was 0.78 indicating strong agreement. The pooled intrarater reliability for only axial oblique images was 0.85, indicating almost perfect agreement. The interclass correlation coefficients for all 50 MRIs was 0.63--0.75, indicating strong agreement. The pooled interrater reliability using only the axial oblique images was 0.84, demonstrating near perfect agreement. Conclusions:The alpha angle is a reliable measure when calculated on axial oblique MRI. Our study indicates that almost perfect agreement exists when measuring the alpha angle on axial oblique MRI.