scholarly journals Inter-rater Reliability of Ultrasound Measurements of the Thickness of the Supraspinatus Tendon, Subacromial Bursa and Biceps Tendon of Young Adults

2017 ◽  
Vol 32 (5) ◽  
pp. 603-607 ◽  
Author(s):  
Nobuhisa OHYA ◽  
Takumi YAMADA ◽  
Yoshinao SATO
Author(s):  
Ashok Srikar Chowdhary ◽  
Naresh Babu Lakshmipathi Nikhil ◽  
Nidhi Hemendra Chandrakar ◽  
Nidhi Raj Buddaraju

Introduction: Shoulder joint is a highly mobile joint but is prone for rotator cuff injuries and dislocations. It is necessary to accurately diagnose rotator cuff and labral injuries so that appropriate plan of action for treatment can be taken. Magnetic Resonance Imaging (MRI) can be used to diagnose and describe the extent of rotator cuff tendon and labral injuries and any secondary rotator cuff muscle abnormalities. Aim: To study the demographic profile of patients presenting with shoulder pain and instability, identify the various rotator cuff injuries causing shoulder pain, identify the rotator cuff interval lesions causing microinstability, identify the various labral and bony pathologies in instability, describe the MRI features of the rotator cuff, rotator cuff interval, labral and bony injuries. Materials and Methods: This study was a cross-sectional study of patients with symptoms of either shoulder pain or instability who underwent MRI evaluation of the shoulder in the Department of Radiodiagnosis, Rajarajeswari Medical College and Hospital, Bengaluru, Karnataka, India, from July 2018 to December 2020. The study population consisted of 54 patients with either shoulder pain or instability who underwent MRI of shoulder. All the MRI scans of the shoulder in this study were performed using 1.5 Tesla Siemens Magnetom Avanto (Tim 76x18) MR machine using a flex coil. Results: The study population consisted of 54 patients comprising of 38 males and 16 females. The age of the patients ranged from 20-77 years. Majority of the patients were older than 50 years constituting about 33.33% of the total study population. Rotator cuff injury was the commonest cause of pain. Tendinosis was the commonest type of rotator cuff injury followed by partial-thickness and full-thickness tendon tears. The commonest grade of tendinosis was mild or grade 1. Supraspinatus tendon was the most commonly affected tendon followed by subscapularis and infraspinatus tendons. Teres minor tendon was normal in all the cases. Anterior instability was the commonest type of instability with equal prevalence of soft tissue Bankart, bony Bankart and Perthes lesions. Biceps pulley lesions resulted in long head of biceps tendon instability, microinstability and internal impingement. Conclusion: Rotator cuff injuries are the commonest cause of shoulder pain and are seen more frequently after the fifth decade. Shoulder instability is most commonly seen in young male adults. Tendinosis is the commonest type of rotator cuff injury. Supraspinatus tendon is the most commonly injured tendon. Anterior instability is the commonest type of shoulder instability. Biceps pulley lesions result in long head of biceps tendon instability, microinstability and internal impingement. MRI can diagnose interstitial or intrasubstance tendon tears which are not visualised on arthroscopy. MRI description of tendon and labral tears, tendon retraction and muscle atrophy can guide the orthopaedician during arthroscopy and in treatmentplanning.


2020 ◽  
Vol 5 (4) ◽  
pp. 2473011420S0047
Author(s):  
Daniel Urness ◽  
Austin R. Thompson ◽  
Erik Ensrud ◽  
James E. Meeker

Category: Ankle; Sports Introduction/Purpose: Achilles tendon ruptures (ATRs) occurred with an incidence of 2.5 per 100,000 person-years in 2016. This rate has been increasing over the last decade and it has been postulated that this is due to the increasing activity level of older people. With a high and increasing incidence of such a significant injury, further investigation must be done to optimize the treatment of ATRs. The degree of tendon lengthening has been correlated with clinical outcomes, with greater elongation being associated with worse outcomes. MRI and ultrasound techniques have been validated in measurement of Achilles tendon. We sought to develop a reliable, reproducible, and accurate measurement technique utilizing the manual palpation of anatomic landmarks that will be cost effective as well as convenient to perform, particularly intraoperatively. Methods: Both lower legs of 10 healthy subjects without history of Achilles tendon injury were examined using ultrasound and anatomic landmark-based measurement techniques. Subjects sat upright on the exam table and legs were held in flexion at the knee with slight external rotation with the ankle held at 90o, allowing the lower leg to rest flat on the exam table. The length from the medial head of the gastrocnemius to the bottom of the non-compressed heal pad was measured by three raters using the ultrasound and anatomic landmark-based techniques for inter-rater reliability. The measurements were repeated one week later for intra-rater reliability. Ultrasound measurements had excellent inter-rater (0.93) and intra-rater (0.82) correlation coefficients, while good inter-rater (0.76) and intra-rater (0.86) correlation coefficients were observed among anatomic landmark-based measurements. Achilles tendon length measured with ultrasound and anatomic landmark-based techniques were compared using a paired t-test. Results: The anatomic landmark-based technique produces longer measurements of the Achilles tendon (23.2 cm (sd 2.6 cm)) compared to measurements made using ultrasound (22.4 cm (sd 2.6)) (p<0.001). On average, the anatomic landmark-based technique measures 0.8 cm (95% Confidence Interval: 0.4, 1.2) longer than the ultrasound technique. The intraclass correlation coefficient between the anatomic landmark-based and ultrasound measurements is 0.90. Conclusion: While the anatomic landmark-based technique produces a longer measurement of the Achilles tendon, it may still be a reproducible measurement tool. If the change in tendon length is of interest, this technique may be a valid and simple way to monitor that variable. Comparison with MRI may be warranted to better determine the accuracy of the anatomic landmark-based Achilles tendon measure. These results compared with MRI may set the stage for further evaluation of this measurement technique in the operating room in subjects undergoing ATR repair.


2020 ◽  
Vol 9 (8) ◽  
pp. 2597
Author(s):  
Annika Danielsson ◽  
Inti Vanmechelen ◽  
Cecilia Lidbeck ◽  
Lena Krumlinde-Sundholm ◽  
Els Ortibus ◽  
...  

Background: The Dyskinesia Impairment Scale (DIS) is a new assessment scale for dystonia and choreoathetosis in children and youth with dyskinetic cerebral palsy. Today, the Burke–Fahn–Marsden Dystonia Rating Scale (BFM) is mostly used to assess dystonia in children with inherited dystonia. The aim of this study was to assess reliability and validity of the DIS in children and youth with inherited or idiopathic dystonia. Methods: Reliability was measured by (1) the intraclass correlation coefficients (ICCs) for inter-rater and test-retest reliability, as well as (2) standard error of measurement (SEM) and minimal detectable difference (MDD). For concurrent validity of the DIS-dystonia subscale, the BFM was administered. Results: In total, 11 males and 9 females (median age 16 years and 7 months, range 6 to 24 years) were included. For inter-rater reliability, the ICCs for the DIS total score and the dystonia and choreoathetosis subscale scores were 0.83, 0.87, and 0.71, respectively. For test-retest reliability, the ICCs for the DIS total score and the dystonia and choreoathetosis subscale scores were 0.95, 0.88, and 0.93, respectively. The SEM and MDD for the total DIS were 3.98% and 11.04%, respectively. The Spearman correlation coefficient between the dystonia subscale and the BFM was 0.88 (p < 0.01). Conclusions: Good to excellent inter-rater, test-retest reliability, and validity were found for the total DIS and the dystonia subscale. The choreoathetosis subscale showed moderate inter-rater reliability and excellent test-retest reliability. The DIS may be a promising tool to assess dystonia and choreoathetosis in children and young adults with inherited or idiopathic dystonia.


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