Inter-Rater Reliability of Magnetic Resonance Imaging in Comparison to Computed Tomography and Wrist Arthroscopy in SLAC and SNAC Wrist

Abstract

The aim of the study was to assess the inter-rater reliability of magnetic resonance imaging (MRI) in comparison to computed tomography (CT) and wrist arthroscopy in patients with scapholunate (SLAC) or scaphoid non-union advanced collapse (SNAC) as well as to evaluate a grading score of cartilage lesions. A total of 42 patients (36 male, 6 female) at a mean age of 45 years (range: 19–65 years) with a SLAC or SNAC wrist who had a preoperative MRI and CT scan as well as underwent arthroscopy of the wrist between 2013 and 2018 were included in this study. Cartilage lesions, as assessed by MRI, CT and wrist arthroscopy, were classified by two hand surgeons in three stages. Inter-rater reliability was evaluated using the Kendall Tau-b test as well as the chi-square test to analyze for trend. The correlation between cartilage lesions, classified by arthroscopy and MRI, was low. A moderate correlation between CT and arthroscopy staging was shown. The highest inter-rater correlation was found between MRI and CT staging. An additionally performed logistic regression showed that progression of cartilage lesions as shown in MRI scans correlates with a restriction of range of motion (ROM). The level of cartilage lesion may be more severely classified in an MRI than during arthroscopy. Arthroscopy remains the gold standard in detecting cartilage lesions and thus in the decision-making process of the definitive treatment in carpal collapse.

Magnetic resonance imaging analysis of the distribution of cartilage damage in scaphoid nonunion

“…A study by Ochman et al (2017) confirmed that the 3.0 T MRI examination with a wrist coil is promising for cartilage assessment and is a much more accurate diagnosis tool compared with the 1.5 T MRI examination. Terzis et al (2021) also demonstrated a strong correlation between 3.0 T MRI and wrist arthroscopy in the assessment of cartilage lesions. They concluded that MRI is a useful diagnostic tool for cartilage assessment in patients with SNAC or SLAC wrist.…”

“…Although arthroscopy remains the gold standard for detecting cartilaginous lesions, magnetic resonance imaging (MRI) is a useful diagnostic tool for cartilaginous lesions of the wrist (Terzis et al., 2021). As treatment can be influenced by the SNAC stage, it is important to assess if the distribution of cartilage damage associated with SNAC follows the same pattern.…”

Citizens can help to map putative transmission sites for snail-borne diseases

“…For all snail genera, snail abundance reported by the CSs were positively correlated with those obtained by the expert. However, the correlation values were lower than those reported in other studies about intercoder reliability [68][69][70]. Nevertheless, most of these studies focus on medical diagnosis, which involves fewer categories of classification, and therefore fewer opportunities for disagreement.…”