TY - JOUR
T1 - Reliability of Magnetic Resonance Imaging Assessment of Rotator Cuff
T2 - The ROW Study
AU - Jain, Nitin B.
AU - Collins, Jamie
AU - Newman, Joel S.
AU - Katz, Jeffrey N.
AU - Losina, Elena
AU - Higgins, Laurence D.
N1 - Publisher Copyright:
© 2015 American Academy of Physical Medicine and Rehabilitation.
PY - 2015/3/1
Y1 - 2015/3/1
N2 - Background: 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.
AB - Background: 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.
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U2 - 10.1016/j.pmrj.2014.08.949
DO - 10.1016/j.pmrj.2014.08.949
M3 - Article
C2 - 25180471
AN - SCOPUS:84925305784
SN - 1934-1482
VL - 7
SP - 245-254.e3
JO - PM and R
JF - PM and R
IS - 3
ER -