Assessment of the reliability of real time ultrasound scanning to measure the humeral head position in a number of glenohumeral joint positions

Abstract

The aim of the current study is to assess the intra-rater and inter-rater reliability of real time ultrasound scanning in measuring static humeral head position. Real time ultrasound scanning, an experimental clinical measurement, was used to record measurements of the humeral head position in a sample of (20) healthy volunteers [9 male, 11 female]. While the participant was seated in a standardized chair, Hips and knees were positioned at 90 degrees of flexion. The humeral head position of each subject was imaged at three ultrasound view [anterior, posterior and superior] in a different arm positions; images were repeated three times for each position by the same examiner on the same day to assess Intra-rater reliability. The Images were then analysed by the researcher and a second investigator to assess inter-tester reliability. Intra-rater and inter-rater reliability were quantified by using the intraclass correlation coefficient and standard error of measurement, the smallest detectable difference values were calculated and were used to estimate the magnitude of change that is predictable to exceed measurement error. The intra-rater reliability for all positions was found to be excellent for all tests ranged from 0.83 to 0.99 respectively. Inter -rater reliability between examiners was found to be good to excellent for all test positions ranged from 0.66 to 0.98, and the standard error of measurement for all positions was less than the calculated mean. This study demonstrates that real time ultrasound scanning is a reliable method of assessing the location of the humeral head in a number of arm positions in healthy subjects when measured by the same examiner and this may suggest that RTUS could be used to assess the impact of rehabilitation programme or surgical interventions for shoulder pathology.

Reliability of point-of-care shoulder ultrasound measurements for subacromial impingement in asymptomatic participants

“…Few studies have reported inter-rater reliability for shoulder US image interpretation, in which different raters measure the same set of images. Our study yielded good to excellent inter-rater reliability for image interpretation, in comparison to previous studies that demonstrated only moderate to good reliability for asymptomatic or symptomatic participants ( 8 , 13 , 16 ). The inter-rater reliability of US measurements that we advocate for use in future studies, AHD in neutral position, and SST, SASDB, and SASDB fluid thickness in short axis, all fell within the excellent range for image interpretation.…”

“…AHD was originally described for radiographs as the shortest distance between the inferior aspect of the acromion and the humeral head, with RTC abnormalities associated with reductions in AHD secondary to superior migration of the humeral head ( 7 ). AHD is by far the most frequently studied shoulder US measurement in reliability studies of asymptomatic ( 8 – 13 ) and symptomatic ( 14 – 22 ) participants, with reported reliability ranging from poor to excellent intra-rater reliability ( 8 – 12 , 19 – 22 ), and moderate to excellent inter-rater reliability ( 13 – 18 ). AGT (acromion-greater tuberosity) distance is the shortest distance between the inferolateral edge of the acromion and the apex of the greater tuberosity and has proven to be useful for examining patients with impingement symptoms ( 23 – 25 ).…”

“…Prior studies examining the inter-rater reliability of image interpretation are limited to AHD measurement only, reporting only moderate to good reliability in asymptomatic or symptomatic participants ( 8 , 13 , 16 ). The inter-rater reliability of image interpretation for other shoulder US measurements relevant to SIS has not been published to date.…”

Biomechanical and neuromuscular characteristics in patients with traumatic anterior shoulder instability undergoing arthroscopic Bankart repair: a clinical prospective cohort study protocol

“…The translation, in millimetres, is calculated by subtracting the distance between the border of the glenoid (posterior view) or the coracoid process (anterior view), respectively, and the border of the humeral head at rest (condition 1) from the conditions with force applied (conditions 2 and 3). The intrarater and inter-rater reliability of the ultrasound assessment has previously been shown good to excellent in the abducted position from an anterior view (ICC 0.95–0.96 and 0.72–0.8, respectively) and posterior view (ICC 0.98 and 0.77–0.85, respectively) 24. The intrarater and inter-rater reliability with the shoulder in neutral position has also previously been shown to be moderate to excellent (ICC 0.85–0.98 and 0.5–0.75, respectively) 14.…”

Combined Effects of Glenohumeral Mobilization, Stretching, and Thoracic Manipulation on Shoulder Internal Rotation Range of Motion

“…Measures of humeral head position assessing anterior landmarks have been shown to have high levels of intra-tester reliability (ICC 0.93), SEM 0.5-1.0mm, SDD 1.6-2.7mm. 47 …”