Interobserver variation in reporting CT arthrograms of the shoulder

Fogerty, S.; King, Derek; Groves, Clare; Scally, Andy J.; Chandramohan, M.

doi:10.1016/j.ejrad.2010.10.009

Cited by 10 publications

(14 citation statements)

References 10 publications

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“…Of these shoulders, 27 were from studies of cadaveric specimens and 2,533 were from studies of clinical patients with anterior shoulder instability. When the articles were further broken down by the evaluated imaging modalities, there were 4 articles on ultrasound, 10,19,29,37 5 articles on radiographic imaging, 11,34,36,37,44 10 articles on MRI, 17,[21][22][23]30,35,38,[48][49][50] 12 articles on MRA, 15,24,25,[27][28][29][31][32][33]40,42,46 2 articles on 2D CT, 35,41 7 articles on CTA, 14,18,19,20,22,24,26 and 5 articles on 3D CT 16,39,43,45,47 (Table 2).…”

Section: Resultsmentioning

confidence: 99%

Accuracy and Reliability of Imaging Modalities for the Diagnosis and Quantification of Hill-Sachs Lesions: A Systematic Review

Vopat

Peebles

McBride

et al. 2021

Arthroscopy: The Journal of Arthroscopic & Related Surgery

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Purpose: To determine the reliability and accuracy of different imaging modalities in assessing Hill-Sachs lesions within the setting of anterior shoulder instability. Methods: A systematic review was performed according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) guidelines using the PubMed, Scopus, Embase, and Cochrane Library databases. The inclusion criteria were clinical trials or cadaveric studies that assessed the accuracy of humeral head bone loss imaging or reliability and English-language articles. The exclusion criteria were animal studies; imaging studies without measures of accuracy, reliability, or clinical predictive power; studies of shoulder injuries without humeral head bone loss; editorials; abstracts; reviews; case reports; and surveys. The search terms included "imaging" OR "radiographic" OR "CT" OR "MRI" AND "Hill-Sachs" OR "humeral head bone loss." Assessment of the methodologic quality of the included studies was performed using the original Quality Assessment of Diagnostic Accuracy Studies (QUADAS) tool. Results: Forty studies (2,560 shoulders) met the inclusion criteria and were assessed. For diagnosing the presence of Hill-Sachs lesions, computed tomography (CT) arthrography had the highest reported accuracy (median, 91%; range, 66%-100%). For the same assessment, CT arthrography also had the greatest reported sensitivity (median, 94%; range, 50%-100%). For the quantification of Hill-Sachs lesion parameters, reported intraobserver reliabilities were highest for 3-dimensional (3D) CT (intraclass correlation coefficient [ICC] range, 0.916-0.999), followed by 2-dimensional CT (ICC range, 0.858-0.861) and magnetic resonance imaging (MRI) (ICC range, 0.28-0.97). For the same quantification parameters, interobserver reliabilities were also reported for 3D CT (ICC range, 0.772-0.996), 2-dimensional CT (ICC range, 0.721-0.879), and MRI (k range, 0.444-0.700). Intraobserver reliabilities for determining glenoid tracking were only reported for 3D CT (k range, 0.730-1.00; ICC range, 0.803-0.901) and MRI (ICC range, 0.770-0.790). Conclusions: This study shows that the current literature supports a variety of different imaging modalities that provide clinically acceptable accuracy in diagnosing and quantifying Hill-Sachs lesions, as well as determining whether they will cause persistent anterior shoulder instability. Furthermore, this systematic review justifies that further research is needed to help develop a treatment algorithm on the proper imaging modalities needed to help treat patients with anterior shoulder instability that is both reliable and financially acceptable. Level of Evidence: Level IV, systematic review of Level I through IV studies.

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Section: Resultsmentioning

confidence: 99%

Accuracy and Reliability of Imaging Modalities for the Diagnosis and Quantification of Hill-Sachs Lesions: A Systematic Review

Vopat

Peebles

McBride

et al. 2021

Arthroscopy: The Journal of Arthroscopic & Related Surgery

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“…Only few previous studies exist on the inter-observer agreement of CT scans of other parts of human body. Two consultant musculoskeletal radiologists evaluated 50 CT arthrograms of the shoulder [12]. The study group found that the level of agreement by Kappa statistic was moderate to fair in most findings (anterior capsular laxity, Hill-Sachs fracture, soft tissue Bankart), demonstrating considerable inter-observer variation [12].…”

Section: Discussionmentioning

confidence: 99%

“…Two consultant musculoskeletal radiologists evaluated 50 CT arthrograms of the shoulder [12]. The study group found that the level of agreement by Kappa statistic was moderate to fair in most findings (anterior capsular laxity, Hill-Sachs fracture, soft tissue Bankart), demonstrating considerable inter-observer variation [12]. The authors highlighted the potential difficulties in reporting such images and suggested ways by which the report could be more focused to provide a clinically reliable report and one that accurately matches the surgical findings [12].…”

Section: Discussionmentioning

confidence: 99%

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Inter-observer agreement of paranasal sinus computed tomography scans

Julkunen

Terna

Numminen

et al. 2016

Acta Oto-Laryngologica

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“…CT arthrography is an alternative method used to diagnose shoulder abnormalities-in particular, labral lesions [3][4][5]. Direct MR and CT arthrography are somewhat invasive procedures, however, and patients often complain afterward of arthrography-related pain [6][7][8][9].…”

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confidence: 99%