G A Bernhardt1, M Glehr, M Zacherl, C Wurnig, G Gruber. 1. Division of General Surgery, Department of Surgery, Medical University of Graz, Auenbruggerplatz 29, 8036, Graz, Austria. gerwin.bernhardt@lkh-oitsberg.at
Abstract
BACKGROUND: An acromiohumeral interval narrower than 6 mm measured on AP shoulder radiographs has been considered pathological and suggestive of rotator cuff tears. This prospective study was conducted to assess inter- and intraobserver variation in the radiographic assessment of the acromiohumeral interval and its critical value on routinely taken AP shoulder radiographs off-study use to evaluate the accuracy of this measurement method. METHODS: The acromiohumeral distance from the inferior anterior acromial aspect to the humeral head was measured in millimeters. Thirty blinded, anteroposterior shoulder radiographs were independently reviewed by five board-certified orthopedic shoulder surgeons at two time points in random order. RESULTS: The results of three investigators showed significant intraobserver variation. Five investigator pairs showed significant interobserver variation at both examination time points. The maximum interobserver difference for the same radiograph was 8 mm (range 0 to 8 mm). CONCLUSION: Our results indicate that the assessment of the acromiohumeral interval using non-standardized anteroposterior radiographs off-study use cannot be seen as a reproducible and reliable method of measurement.
BACKGROUND: An acromiohumeral interval narrower than 6 mm measured on AP shoulder radiographs has been considered pathological and suggestive of rotator cuff tears. This prospective study was conducted to assess inter- and intraobserver variation in the radiographic assessment of the acromiohumeral interval and its critical value on routinely taken AP shoulder radiographs off-study use to evaluate the accuracy of this measurement method. METHODS: The acromiohumeral distance from the inferior anterior acromial aspect to the humeral head was measured in millimeters. Thirty blinded, anteroposterior shoulder radiographs were independently reviewed by five board-certified orthopedic shoulder surgeons at two time points in random order. RESULTS: The results of three investigators showed significant intraobserver variation. Five investigator pairs showed significant interobserver variation at both examination time points. The maximum interobserver difference for the same radiograph was 8 mm (range 0 to 8 mm). CONCLUSION: Our results indicate that the assessment of the acromiohumeral interval using non-standardized anteroposterior radiographs off-study use cannot be seen as a reproducible and reliable method of measurement.
Authors: J T Lehtinen; E A Belt; C O Lybäck; M J Kauppi; K Kaarela; H J Kautiainen; M U Lehto Journal: J Shoulder Elbow Surg Date: 2000 May-Jun Impact factor: 3.019
Authors: Nadja Saupe; Christian W A Pfirrmann; Marius R Schmid; Bernhard Jost; Clément M L Werner; Marco Zanetti Journal: AJR Am J Roentgenol Date: 2006-08 Impact factor: 3.959
Authors: Peter N Chalmers; Dane H Salazar; Karen Steger-May; Aaron M Chamberlain; Georgia Stobbs-Cucchi; Ken Yamaguchi; Jay D Keener Journal: J Shoulder Elbow Surg Date: 2016-08-31 Impact factor: 3.019