Feasibility of the acromion index as a reference of severity of stratified supraspinatus tendon injury: a secondary analysis

2020 ◽  
Vol 61 (12) ◽  
pp. 1661-1667
Author(s):  
Hyoung Seop Kim ◽  
Seung Ho Joo ◽  
Hyun Sun Lim ◽  
Hye Won Kim
Keyword(s):  
Intraclass Correlation ◽  
Secondary Analysis ◽  
Correlation Coefficients ◽  
Supraspinatus Tendon ◽  
Tendon Injury ◽  
Statistical Correlation ◽  
Full Thickness ◽  
X Ray ◽  
Magnetic Resonance Imaging Mri ◽  
Acromion Index

Background The acromion index (AI) is the acromial lateral extension above the head of the humerus. Some researchers have advocated that the AI indicates the severity of the tear size of the full-thickness supraspinatus tendon. Purpose To validate the reproducibility of the AI between shoulder magnetic resonance imaging (MRI) and standard X-ray and to verify whether the AI is a useful index for stratifying the severity of supraspinatus tendon injuries, as well as full-thickness tears. Material and Methods We enrolled 200 patients with impingement syndrome who were subsequently evaluated with standard X-ray of the shoulder in the anteroposterior view, as well as an MRI. We performed a pilot study to validate the reproducibility of the AI using standard X-ray and MRI, and to compare the AI between these imaging modalities. The severity of supraspinatus tendon injury was classified into four groups (0 = no evidence of injury, 1 = partial tear, 2 = full-thickness tear, and 3 = complete rupture) based on an official reading of the shoulder MRI. We compared the AIs of both modalities between the groups. Results Intraclass correlation coefficients of the AIs between the two examiners were 0.819 for MRI and 0.808 for plain X-ray. The mean AI from standard X-ray was greater than that from MRI ( P<0.0001). There was no statistical correlation between the AI and the severity of supraspinatus tendon injury. Conclusion Our findings indicate that the AI cannot be generally used as a predictive reference for the stratified severities of supraspinatus tendon injury.

scholarly journals Agreement Between Dual-Energy X-Ray Absorptiometry and Quantitative Ultrasound to Evaluate Bone Health in Adolescents: The PRO-BONE Study

2018 ◽  
Vol 30 (4) ◽  
pp. 466-473 ◽  
Author(s):  
Ana Torres-Costoso ◽  
Dimitris Vlachopoulos ◽  
Esther Ubago-Guisado ◽  
Asunción Ferri-Morales ◽  
Iván Cavero-Redondo ◽  
...  
Keyword(s):  
Quantitative Ultrasound ◽  
Bone Health ◽  
Intraclass Correlation ◽  
Broadband Ultrasound Attenuation ◽  
Correlation Coefficients ◽  
Dual Energy ◽  
Stiffness Index ◽  
X Ray ◽  
Intraclass Correlation Coefficients ◽  
Bivariate Correlation

Purpose: The present study aims to investigate the association between dual-energy X-ray absorptiometry (DXA) and quantitative ultrasound (QUS) parameters and the intermethods agreement in active males. Methods: In this cross-sectional study, bone health (by DXA and calcaneal QUS), physical activity (by accelerometers), and anthropometrics measurements were assessed in 117 active adolescents (12–14 y old). Bivariate correlation coefficients were calculated to assess the relationships between DXA standard regions of interest and QUS parameters. Intraclass correlation coefficients and Bland–Altman plots were used to assess the level of agreement between bone mineral content regions derived from DXA and stiffness index. The measurements were z score transformed for comparison. Results: Most QUS parameters were positive and significantly correlated with DXA outcomes (stiffness index: r = .43–.52; broadband ultrasound attenuation: r = .50–.58; speed of sound: r = .25–.27) with the hip showing the highest correlations. Moreover, the present study found fair to good intraclass correlation coefficients of agreement (.60–.68) between DXA and QUS to assess bone health. The Bland–Altman analysis showed a limited percentage of outliers (3.2%–8.6%). Conclusion: QUS device could represent an acceptable alternative method to assess bone health in active adolescent males.

scholarly journals Idiopathic Normal Pressure Hydrocephalus: Cerebral Perfusion Measured with pCASL before and Repeatedly after CSF Removal

2014 ◽  
Vol 34 (11) ◽  
pp. 1771-1778 ◽  
Author(s):  
Johan Virhammar ◽  
Katarina Laurell ◽  
André Ahlgren ◽  
Kristina Giuliana Cesarini ◽  
Elna-Marie Larsson
Keyword(s):  
White Matter ◽  
Normal Pressure Hydrocephalus ◽  
Intraclass Correlation ◽  
Correlation Coefficients ◽  
Normal Pressure ◽  
Idiopathic Normal Pressure Hydrocephalus ◽  
Regional Variability ◽  
Mri Scans ◽  
Magnetic Resonance Imaging Mri ◽  
Gait Function

Pseudo-continuous arterial spin labeling (pCASL) measurements were performed in 20 patients with idiopathic normal pressure hydrocephalus (iNPH) to investigate whether cerebral blood flow (CBF) increases during the first 24 hours after a cerebrospinal fluid tap test (CSF TT). Five pCASL magnetic resonance imaging (MRI) scans were performed. Two scans were performed before removal of 40 mL CSF, and the other three at 30 minutes, 4 hours, and 24 hours, respectively after the CSF TT. Thirteen different regions of interest (ROIs) were manually drawn on coregistered MR images. In patients with increased CBF in lateral and frontal white matter after the CSF TT, gait function improved more than it did in patients with decreased CBF in these regions. However, in the whole sample, there was no significant increase in CBF after CSF removal compared with baseline investigations. The repeatability of CBF measurements at baseline was high, with intraclass correlation coefficients of 0.60 to 0.90 for different ROIs, but the median regional variability was in the range of 5% to 17%. Our results indicate that CBF in white matter close to the lateral ventricles plays a role in the reversibility of symptoms after CSF removal in patients with iNPH.

scholarly journals Magnetic resonance imaging based coracoid morphology and its associations with subscapularis tears: a new index

2017 ◽  
Vol 11 (1_suppl) ◽  
pp. 52-58 ◽  
Author(s):  
Adam C. Watson ◽  
Richard P. Jamieson ◽  
Andrew C. Mattin ◽  
Richard S. Page
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Sagittal Plane ◽  
Intraclass Correlation ◽  
Correlation Coefficients ◽  
Resonance Imaging ◽  
Intraclass Correlation Coefficients ◽  
Arm Position ◽  
Magnetic Resonance Imaging Mri

Background We aimed to assess the validity of magnetic resonance imaging (MRI) in assessing the subcorocoid space and determine the validity of novel sagittal plane subcorocoid space measurements. Methods We assessed 33 arthroscopically proven subscapularis tears with MRIs compared to 33 (instability) controls with normal subscapularis tendons. Three examiners analyzed MRIs for seven static indices of corocoid morphology, in axial and sagittal planes. We explored reviewer variation using intraclass correlation coefficients (ICC) and differences between the two groups was explored using t-tests. Results Groups were similar in characteristics but different in age (cases = 53, controls = 23). ICC showed good (2/7) or excellent (5/7) reliability. Small differences(<1.6 mm) were identified between subscapularis tears and controls in coraco–humeral distance, in axial ( p = 0.092) and sagittal planes ( p = 0.045). There were statistically significant differences between groups when analyzing the angular projection of the coracoid from the glenoid, in both sagittal ( p < 0.0001) and axial planes ( p = 0.045). Conclusions Acute inferior angulation of the corocoid in the sagittal plane may be associated with subscapularis tears. Static indices are measured within the scapula and not affected by arm position. MRI reliably provided a platform to assess the coracoid. Based on this, we currently consider corocoplasty in patients with subscapularis tears and a sagittal coroco–glenoid angle <60o to reduce potential impingement.

scholarly journals The reliability of the augmented Lehnert-Schroth and Rigo classification in scoliosis management

2021 ◽  
Vol 77 (2) ◽  
Author(s):  
Burçin Akçay ◽  
Tuğba Kuru Çolak ◽  
Adnan Apti ◽  
İlker Çolak ◽  
Önder Kızıltaş
Keyword(s):  
Treatment Plan ◽  
Intraclass Correlation ◽  
Correlation Coefficients ◽  
Error Measurement ◽  
X Rays ◽  
X Ray ◽  
Intraclass Correlation Coefficients ◽  
Observer Reliability ◽  
The Individual ◽  
Curve Patterns

Background: In pattern-specific scoliosis exercises and bracing, the corrective treatment plan differs according to different curve patterns. There are a limited number of studies investigating the reliability of the commonly used classifications systems.Objective: To test the reliability of the augmented Lehnert-Schroth (ALS) classification and the Rigo classification.Methods: X-rays and posterior photographs of 45 patients with scoliosis were sent by the first author to three clinicians twice at 1-week intervals. The clinicians classified images according to the ALS and Rigo classifications, and the data were analysed using SPSS V-16. Intraclass correlation coefficients (ICCs) and standard error measurement (SEM) were calculated to evaluate the inter- and intra-observer reliability.Results: The inter-observer ICC values were 0.552 (ALS), 0.452 (Rigo) for X-ray images and 0.494 (ALS), 0.518 (Rigo) for the photographs. The average intra-observer ICC value was 0.720 (ALS), 0.581 (Rigo) for the X-ray images and 0.726 (ALS) and 0.467 (Rigo) for the photographs.Conclusions: The results of our study indicate moderate inter-observer reliability for X-ray images using the ALS classification and clinical photographs using the Rigo classification. Intra-observer reliability was moderate to good for X-ray images and clinical photographs using the ALS classification and poor to moderate for X-ray and clinical photographs using the Rigo classification.Clinical implications: Pattern classifications assist in creating a plan and indication of correction in specific scoliosis physiotherapy and pattern-specific brace applications and surgical treatment. More sub-types are needed to address the individual patterns of curvature. The optimisation of curve classification will likely reduce failures in diagnosis and treatment.

scholarly journals Real-world keystroke dynamics are a potentially valid biomarker for clinical disability in multiple sclerosis

2020 ◽  
pp. 135245852096879
Author(s):  
KH Lam ◽  
KA Meijer ◽  
FC Loonstra ◽  
EME Coerver ◽  
J Twose ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Intraclass Correlation ◽  
Surrogate Marker ◽  
Reliability And Validity ◽  
Correlation Coefficients ◽  
Clinical Aspects ◽  
Keystroke Dynamics ◽  
Intraclass Correlation Coefficients ◽  
Magnetic Resonance Imaging Mri ◽  
Clinical Measures

Background: Clinical measures in multiple sclerosis (MS) face limitations that may be overcome by utilising smartphone keyboard interactions acquired continuously and remotely during regular typing. Objective: The aim of this study was to determine the reliability and validity of keystroke dynamics to assess clinical aspects of MS. Methods: In total, 102 MS patients and 24 controls were included in this observational study. Keyboard interactions were obtained with the Neurokeys keyboard app. Eight timing-related keystroke features were assessed for reliability with intraclass correlation coefficients (ICCs); construct validity by analysing group differences (in fatigue, gadolinium-enhancing lesions on magnetic resonance imaging (MRI), and patients vs controls); and concurrent validity by correlating with disability measures. Results: Reliability was moderate in two (ICC = 0.601 and 0.742) and good to excellent in the remaining six features (ICC = 0.760–0.965). Patients had significantly higher keystroke latencies than controls. Latency between key presses correlated the highest with Expanded Disability Status Scale ( r = 0.407) and latency between key releases with Nine-Hole Peg Test and Symbol Digit Modalities Test (ρ = 0.503 and r = −0.553, respectively), ps < 0.001. Conclusion: Keystroke dynamics were reliable, distinguished patients and controls, and were associated with clinical disability measures. Consequently, keystroke dynamics are a promising valid surrogate marker for clinical disability in MS.

Disproportionate fluid sign as an aid in diagnosing high-grade bursal-sided supraspinatus tendon tear

2017 ◽  
Vol 59 (9) ◽  
pp. 1102-1109
Author(s):  
Seonji Jeong ◽  
Ja-Young Choi ◽  
Yu Suhn Kang ◽  
Hye Jin Yoo ◽  
Sae Hoon Kim ◽  
...  
Keyword(s):  
Glenohumeral Joint ◽  
Characteristic Curve ◽  
Supraspinatus Tendon ◽  
Observer Agreement ◽  
High Grade ◽  
Full Thickness ◽  
Relative Paucity ◽  
Partial Thickness ◽  
Magnetic Resonance Imaging Mri ◽  
Sensitivity Specificity

Background Deep, high-grade bursal-sided supraspinatus tendon tears are sometimes preoperatively misinterpreted as full-thickness tears on shoulder magnetic resonance imaging (MRI). Purpose To determine the usefulness of disproportionate fluid sign for differentiating high-grade bursal-sided partial-thickness tears from full-thickness tears on conventional MRI. Material and Methods Preoperative MRIs of 198 patients with arthroscopically confirmed high-grade bursal-sided partial-thickness tears and full-thickness tears were independently reviewed by two readers on two occasions. The presence of high-grade bursal-sided partial-thickness tears with a confidence level using a five-point grading scale was assessed based on tear depth alone and also in combination with disproportionate fluid sign, defined as a prominent subdeltoid or subacromial-subdeltoid bursal fluid distension with a relative paucity of effusion in the glenohumeral joint. The sensitivity, specificity, accuracy, and area under the receiver operating characteristic curve (AUC) were calculated, as well as inter-observer reliability. Results The disproportionate fluid sign was identified in 60/74 (81.2%) bursal-sided partial-thickness tears and 9/124 (7.5%) full-thickness tears. The sensitivity and accuracy of the diagnosis of bursal-sided tear were higher when disproportionate fluid sign was used in conjunction with the tear depth, compared with tear depth alone ( P < 0.001). There was excellent inter-observer agreement for disproportionate fluid sign and deep bursal-sided tear. The AUCs were significantly higher in combination with disproportionate fluid sign. Conclusion The disproportionate fluid sign indicates the presence of a deep, high-grade bursal-sided partial-thickness tear, which can be misinterpreted as a full-thickness tear. Thus, it can provide greater diagnostic assistance to less-experienced radiologists and clinicians.

scholarly journals Development and Validation of the OMERACT Rheumatoid Arthritis Magnetic Resonance Tenosynovitis Scoring System in a Multireader Exercise

2017 ◽  
Vol 44 (11) ◽  
pp. 1688-1693 ◽  
Author(s):  
Daniel Glinatsi ◽  
Paul Bird ◽  
Frédérique Gandjbakhch ◽  
Espen A. Haavardsholm ◽  
Charles G. Peterfy ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Magnetic Resonance ◽  
Scoring System ◽  
Intraclass Correlation ◽  
Correlation Coefficients ◽  
Change Score ◽  
Change Scores ◽  
Smallest Detectable Change ◽  
Magnetic Resonance Imaging Mri ◽  
Development And Validation

Objective.To develop and validate a magnetic resonance imaging (MRI) tenosynovitis (TS) score for tendons at the wrist and metacarpophalangeal (MCP) joint levels in patients with rheumatoid arthritis (RA).Methods.Axial T1-weighted precontrast and postcontrast fat-saturated MR image sets of the hands of 43 patients with RA initiating rituximab therapy were obtained at baseline and after 14, 26, 38, or 52 weeks. The MR images were scored twice by 4 readers. Nine tendon compartments of the wrist and 4 flexor tendon compartments at the MCP joints were assessed. Tenosynovitis was scored as follows: 0: No; 1: < 1.5 mm; 2: ≥ 1.5 mm but < 3 mm; 3: ≥ 3 mm peritendinous effusion and/or postcontrast enhancement. Intrareader and interreader intraclass correlation coefficients (ICC), smallest detectable change (SDC), percentage of exact and close agreement (PEA/PCA), and standardized response mean (SRM) were calculated.Results.Intrareader and interreader ICC for status and change scores were very good (≥ 0.80) for total scores for all readers. Intrareader SDC was ≤ 3.0 and interreader SDC was < 2.0. The overall PEA/PCA intrareader and interreader agreements for change scores in all tendons were 73.8%/97.6% and 47.9%/85.0%, respectively. Average SRM was moderate for total scores and 60.5% of the patients had a tenosynovitis change score ≥ SDC.Conclusion.The TS score showed high intrareader and interreader agreement for wrist and finger tendons, with moderate responsiveness, and the majority of the patients showed a change above the SDC. This scoring system may be included as a component of the RAMRIS.

scholarly journals A Novel Shorthand Approach to Knee Bone Age Using MRI: A Validation and Reliability Study

2021 ◽  
Vol 9 (8) ◽  
pp. 232596712110215
Author(s):  
Blake C. Meza ◽  
Scott M. LaValva ◽  
Julien T. Aoyama ◽  
Christopher J. DeFrancesco ◽  
Brendan M. Striano ◽  
...  
Keyword(s):  
Skeletal Maturity ◽  
Intraclass Correlation ◽  
Age Determination ◽  
Correlation Coefficients ◽  
Bone Age ◽  
Intrarater Reliability ◽  
Level Of Evidence ◽  
Knee Mri ◽  
Level Of Training ◽  
Magnetic Resonance Imaging Mri

Background: Bone-age determination remains a difficult process. An atlas for bone age has been created from knee-ossification patterns on magnetic resonance imaging (MRI), thereby avoiding the need for radiographs and associated costs, radiation exposure, and clinical inefficiency. Shorthand methods for bone age can be less time-consuming and require less extensive training as compared with conventional methods. Purpose: To create and validate a novel shorthand algorithm for bone age based on knee MRIs that could correlate with conventional hand bone age and demonstrate reliability across medical trainees. Study Design: Cohort study (diagnosis); Level of evidence, 2. Methods: Included in this study were adolescent patients who underwent both knee MRI and hand bone age radiographs within 90 days between 2009 and 2018. A stepwise algorithm for predicting bone age using knee MRI was developed separately for male and female patients, and 7 raters at varying levels of training used the algorithm to determine the bone age for each MRI. The shorthand algorithm was validated using Spearman rho ( rS) to correlate each rater’s predicted MRI bone age with the recorded Greulich and Pyle (G&P) hand bone age. Interrater and intrarater reliability were also calculated using intraclass correlation coefficients (ICCs). Results: A total of 38 patients (44.7% female) underwent imaging at a mean age of 12.8 years (range, 9.3-15.7 years). Shorthand knee MRI bone age scores were strongly correlated with G&P hand bone age ( rS = 0.83; P < .001). The shorthand algorithm was a valid predictor of G&P hand bone age regardless of level of training, as medical students ( rS = 0.75), residents ( rS = 0.81), and attending physicians ( rS = 0.84) performed similarly. The interrater reliability of our shorthand algorithm was 0.81 (95% CI, 0.73-0.88), indicating good to excellent interobserver agreement. Respondents also demonstrated consistency, with 6 of 7 raters demonstrating excellent intrarater reliability (median ICC, 0.86 [range, 0.68-0.96]). Conclusion: This shorthand algorithm is a consistent, reliable, and valid way to determine skeletal maturity using knee MRI in patients aged 9 to 16 years and can be utilized across different levels of orthopaedic and radiographic expertise. This method is readily applicable in a clinical setting and may reduce the need for routine hand bone age radiographs.

scholarly journals The OMERACT MRI in Enthesitis Initiative: Definitions of Key Pathologies, Suggested MRI Sequences, and a Novel Heel Enthesitis Scoring System

2019 ◽  
Vol 46 (9) ◽  
pp. 1232-1238 ◽  
Author(s):  
Ashish J. Mathew ◽  
Simon Krabbe ◽  
Iris Eshed ◽  
Frédérique Gandjbakhch ◽  
Paul Bird ◽  
...  
Keyword(s):  
Scoring System ◽  
Intraclass Correlation ◽  
Correlation Coefficients ◽  
Resonance Imaging ◽  
Status Change ◽  
Intraclass Correlation Coefficients ◽  
Patient Level ◽  
Lesion Level ◽  
Mri Sequences ◽  
Magnetic Resonance Imaging Mri

Objective.To develop and validate an enthesitis magnetic resonance imaging (MRI) scoring system for spondyloarthritis/psoriatic arthritis, using the heel as model.Methods.Consensus definitions of key pathologies and 3 heel enthesitis multireader scoring exercises were done, separated by discussion, training, and calibration.Results.Definitions for bone and soft tissue pathologies were agreed. In the final exercise, median pairwise single-measures intraclass correlation coefficients (ICC; patient-level) for entheseal inflammation status/change scores were 0.83/0.82 for all readers. For radiologists and selected rheumatologists, ICC were 0.91/0.84 and quadratic-weighted κ (lesion-level) 0.57–0.91/0.45–0.81.Conclusion.The proposed definitions and Heel Enthesitis Scoring System (HEMRIS) are reliable among trained readers and promising for clinical trials.

scholarly journals Iterative Development and Reliability of the OMERACT Hand Osteoarthritis MRI Scoring System

2013 ◽  
Vol 41 (2) ◽  
pp. 386-391 ◽  
Author(s):  
Ida K. Haugen ◽  
Mikkel Østergaard ◽  
Iris Eshed ◽  
Fiona M. McQueen ◽  
Paul Bird ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
Scoring System ◽  
Task Force ◽  
Intraclass Correlation ◽  
Correlation Coefficients ◽  
Hand Osteoarthritis ◽  
Process Selection ◽  
Mri Features ◽  
Mri Scans ◽  
Magnetic Resonance Imaging Mri

Objective.To develop and test the interreader reliability of the OMERACT Hand Osteoarthritis Magnetic Resonance Scoring System (HOAMRIS) for assessment of structural and inflammatory hand OA features in the interphalangeal joints.Methods.The HOAMRIS was developed through an iterative process. Selection of features and their scaling was agreed upon through consensus by members of the OMERACT Magnetic Resonance Imaging (MRI) Task Force, using the Oslo Hand Osteoarthritis (OA) MRI Score system as a template. Two reliability exercises were performed, in which 6 and 4 readers participated, respectively. After the first exercise, an atlas was developed and used in the second exercise to facilitate reading. In each exercise, readers independently scored 8 MRI scans from the Oslo Hand OA cohort (coronal/axial short-tau inversion recovery and coronal/axial/sagittal T1-weighted fat-suppressed pre-/post-Gadolinium images). Interreader reliability was assessed by intraclass correlation coefficients (ICC), percentage exact and close agreement (PEA/PCA).Results.The preliminary OMERACT HOAMRIS included assessment of synovitis, erosive damage, cysts, osteophytes, cartilage space loss, malalignment, and bone marrow lesions (BML), of which all were scored on a 0–3 scale for normal, mild, moderate, and severe (increments of 0.5 for synovitis, erosive damage, and BML). In the first exercise, most features showed good to very good ICC values (0.64–0.94), except synovitis (0.34). In the second exercise using the atlas, the ICC values were > 0.74 for all MRI features, and the PEA/PCA values were higher than in the first exercise.Conclusion.A preliminary HOAMRIS with good to very good interreader reliability was developed. Longitudinal studies are needed to assess its sensitivity to change.

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