Article

Physiatrists encounter patients with rotator cuff disorders, and
imaging is frequently an important component of their diagnostic assessment.
However, there is a paucity of literature on the reliability of magnetic
resonance imaging (MRI) assessment between shoulder specialists and
musculoskeletal radiologists. OBJECTIVE: We assessed inter- and intrarater
reliability of MRI characteristics of the rotator cuff.
DESIGN: Cross-sectional
secondary analyses in a prospective cohort study. SETTING: Academic tertiary care
centers. PATIENTS: Subjects with shoulder pain were recruited from orthopedic and
physiatry clinics. METHODS:
Two shoulder-fellowship-trained physicians (a
physiatrist and a shoulder surgeon) jointly performed a blinded composite MRI
review by consensus of 31 subjects with shoulder pain. Subsequently, MRI was
reviewed by one fellowship-trained musculoskeletal radiologist. MAIN OUTCOME
MEASUREMENTS: We calculated the Cohen kappa coefficients and percentage agreement
among the 2 reviews (composite review of 2 shoulder specialists versus that of
the musculoskeletal radiologist). Intrarater reliability was assessed among the
shoulder specialists by performing a repeated blinded composite MRI review. In
addition to this repeated composite review, only one of the physiatry shoulder
specialists performed an additional review. RESULTS: Interrater reliability
(shoulder specialists versus musculoskeletal radiologist) was substantial for the
presence or absence of tear (kappa 0.90 [95% confidence interval {CI},
0.72-1.00]), tear thickness (kappa 0.84 [95% CI, 0.70-0.99]), longitudinal size
of tear (kappa 0.75 [95% CI, 0.44-1.00]), fatty infiltration (kappa 0.62 [95% CI,
0.45-0.79]), and muscle atrophy (kappa 0.68 [95% CI, 0.50-0.86]). There was only
fair interrater reliability of the transverse size of tear (kappa 0.20 [95% CI,
0.00-0.51]). The kappa for intrarater reliability was high for tear thickness
(0.88 [95% CI, 0.72-1.00]), longitudinal tear size (0.61 [95% CI, 0.22-0.99]),
fatty infiltration (0.89 [95% CI, 0.80,-0.98]), and muscle atrophy (0.87 [95% CI,
0.76-0.98]). Intrarater reliability for the individual shoulder specialist was
similar to that of the composite reviews. CONCLUSIONS:
There was high interrater
and intrarater reliability for most findings on shoulder MRI. Analysis of our
data supports the reliability of MRI assessment by shoulder specialists for
rotator cuff disorders.
CI - Copyright (c) 2015 American Academy of Physical Medicine and Rehabilitation.
Published by Elsevier Inc. All rights reserved.

Langue : ANGLAIS