Arnlaug Wangensteen1, Johannes L Tol2, Frank W Roemer3, Roald Bahr4, H Paul Dijkstra5, Michel D Crema6, Abdulaziz Farooq5, Ali Guermazi7. 1. Aspetar, Orthopaedic and Sports Medicine Hospital, Doha, Qatar; Oslo Sports Trauma Research Center, Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway. Electronic address: arnlaug.wangensteen@nih.no. 2. Aspetar, Orthopaedic and Sports Medicine Hospital, Doha, Qatar; Amsterdam Center for Evidence Sports Medicine, Academic Medical Center, The Netherlands; The Sports Physician Group, OLVG, Amsterdam, The Netherlands. Electronic address: johannes.tol@aspetar.com. 3. Quantitative Imaging Center, Department of Radiology, Boston University School of Medicine, Boston, MA, USA; Department of Radiology, University of Erlangen-Nuremberg, Erlangen, Germany. 4. Aspetar, Orthopaedic and Sports Medicine Hospital, Doha, Qatar; Oslo Sports Trauma Research Center, Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway. 5. Aspetar, Orthopaedic and Sports Medicine Hospital, Doha, Qatar. 6. Quantitative Imaging Center, Department of Radiology, Boston University School of Medicine, Boston, MA, USA; Department of Radiology, Saint-Antoine Hospital, University Paris VI, Paris, France. 7. Quantitative Imaging Center, Department of Radiology, Boston University School of Medicine, Boston, MA, USA.
Abstract
OBJECTIVE: To assess and compare the intra- and interrater reliability of three different MRI grading and classification systems after acute hamstring injury. METHODS: Male athletes (n=40) with clinical diagnosis of acute hamstring injury and MRI ≤5days were selected from a prospective cohort. Two radiologists independently evaluated the MRIs using standardised scoring form including the modified Peetrons grading system, the Chan acute muscle strain injury classification and the British Athletics Muscle Injury Classification. Intra-and interrater reliability was assessed with linear weighted kappa (κ) or unweighted Cohen's κ and percentage agreement was calculated. RESULTS: We observed 'substantial' to 'almost perfect' intra- (κ range 0.65-1.00) and interrater reliability (κ range 0.77-1.00) with percentage agreement 83-100% and 88-100%, respectively, for severity gradings, overall anatomical sites and overall classifications for the three MRI systems. We observed substantial variability (κ range -0.05 to 1.00) for subcategories within the Chan classification and the British Athletics Muscle Injury Classification, however, the prevalence of positive scorings was low for some subcategories. CONCLUSIONS: The modified Peetrons grading system, overall Chan classification and overall British Athletics Muscle Injury Classification demonstrated 'substantial' to 'almost perfect' intra- and interrater reliability when scored by experienced radiologists. The intra- and interrater reliability for the anatomical subcategories within the classifications remains unclear.
OBJECTIVE: To assess and compare the intra- and interrater reliability of three different MRI grading and classification systems after acute hamstring injury. METHODS: Male athletes (n=40) with clinical diagnosis of acute hamstring injury and MRI ≤5days were selected from a prospective cohort. Two radiologists independently evaluated the MRIs using standardised scoring form including the modified Peetrons grading system, the Chan acute muscle strain injury classification and the British Athletics Muscle Injury Classification. Intra-and interrater reliability was assessed with linear weighted kappa (κ) or unweighted Cohen's κ and percentage agreement was calculated. RESULTS: We observed 'substantial' to 'almost perfect' intra- (κ range 0.65-1.00) and interrater reliability (κ range 0.77-1.00) with percentage agreement 83-100% and 88-100%, respectively, for severity gradings, overall anatomical sites and overall classifications for the three MRI systems. We observed substantial variability (κ range -0.05 to 1.00) for subcategories within the Chan classification and the British Athletics Muscle Injury Classification, however, the prevalence of positive scorings was low for some subcategories. CONCLUSIONS: The modified Peetrons grading system, overall Chan classification and overall British Athletics Muscle Injury Classification demonstrated 'substantial' to 'almost perfect' intra- and interrater reliability when scored by experienced radiologists. The intra- and interrater reliability for the anatomical subcategories within the classifications remains unclear.
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