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http://dx.doi.org/10.5397/cise.2021.00115

Interobserver agreement for detecting Hill-Sachs lesions on magnetic resonance imaging  

Alkaduhimi, Hassanin (Shoulder and Elbow Unit, Joint Research, OLVG Hospital)
Saarig, Aimane (Shoulder and Elbow Unit, Joint Research, OLVG Hospital)
Amajjar, Ihsan (Shoulder and Elbow Unit, Joint Research, OLVG Hospital)
van der Linde, Just A. (Department of Orthopedic Surgery and Traumatology, Reinier Haga Orthopedisch Centrum)
van Wier, Marieke F. (Shoulder and Elbow Unit, Joint Research, OLVG Hospital)
Willigenburg, Nienke W. (Shoulder and Elbow Unit, Joint Research, OLVG Hospital)
van den Bekerom, Michel P.J. (Shoulder and Elbow Unit, Joint Research, OLVG Hospital)
Publication Information
Clinics in Shoulder and Elbow / v.24, no.2, 2021 , pp. 98-105 More about this Journal
Abstract
Background: Our aim is to determine the interobserver reliability for surgeons to detect Hill-Sachs lesions on magnetic resonance imaging (MRI), the certainty of judgement, and the effects of surgeon characteristics on agreement. Methods: Twenty-nine patients with Hill-Sachs lesions or other lesions with a similar appearance on MRIs were presented to 20 surgeons without any patient characteristics. The surgeons answered questions on the presence of Hill-Sachs lesions and the certainty of diagnosis. Interobserver agreement was assessed using the Fleiss' kappa (κ) and percentage of agreement. Agreement between surgeons was compared using a technique similar to the pairwise t-test for means, based on large-sample linear approximation of Fleiss' kappa, with Bonferroni correction. Results: The agreement between surgeons in detecting Hill-Sachs lesions on MRI was fair (69% agreement; κ, 0.304; p<0.001). In 84% of the cases, surgeons were certain or highly certain about the presence of a Hill-Sachs lesion. Conclusions: Although surgeons reported high levels of certainty for their ability to detect Hill-Sachs lesions, there was only a fair amount of agreement between surgeons in detecting Hill-Sachs lesions on MRI. This indicates that clear criteria for defining Hill-Sachs lesions are lacking, which hampers accurate diagnosis and can compromise treatment.
Keywords
Observer variation; Shoulder; Joint instability; Bankart lesions; Hill-Sachs;
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