Reliability of Determining and Measuring Acromial Enthesophytes

Keith M. Baumgarten, MD
Sports Medicine and Shoulder Surgery Section, Orthopedic Institute

James L. Carey, MD, MPH
Department of Orthopaedics and Rehabilitation, Vanderbilt University Medical Center

Joseph A. Abboud, MD
Shoulder and Elbow Service, Department of Orthopaedic Surgery, University of Pennsylvania Health System

Grant L. Jones, MD
Department of Orthopaedic Surgery, The Ohio State University

John E. Kuhn, MD
Department of Orthopaedics and Rehabilitation, Vanderbilt University Medical Center

Brian R. Wolf, MD, MS
Department of Orthopaedic Surgery, University of Iowa Hospitals and Clinics

Robert H. Brophy, MD
Department of Orthopaedic Surgery, Washington University of Medicine

Charles L. Cox, MD
Department of Orthopaedics and Rehabilitation, Vanderbilt University Medical Center

Rick W. Wright, MD
Department of Orthopaedic Surgery, Washington University of Medicine

Armando F. Vidal, MD
Sports Medicine and Shoulder Service, Department of Orthopaedic Surgery, University of Colorado School of Medicine

Benjamin Ma, MD
Department of Orthopaedic Surgery, University of California, San Francisco

Eric C. McCarty, MD
Department of Orthopaedic Surgery, University of Colorado School of Medicine

G. Brian Holloway, MD
Shoulder and Elbow Institute, Knoxville Orthopaedic Clinic

Edwin E. Spencer Jr, MD
Shoulder and Elbow Institute, Knoxville Orthopaedic Clinic

Warren R. Dunn, MD, MPH
Department of Orthopaedics & Rehabilitation, Health Sciences Research Center, Vanderbilt University Medical Center


Abstract

Background 
Although the reliability of determining acromial morphology has been examined, to date, there has not been an analysis of interobserver and intraobserver reliability on determining the presence and measuring the size of an acromial enthesophyte.

Questions/Purposes 
The hypothesis of this study was that there will be poor intraobserver and interobserver reliability in the (1) determination of the presence of an acromial enthesophyte, (2) determination of the size of an acromial enthesophyte, and (3) determination of acromial morphology.

Patients and Methods 
Fifteen fellowship-trained orthopedic shoulder surgeons reviewed the radiographs of 15 patients at two different intervals. Measurement of acromial enthesophytes was performed using two techniques: (1) enthesophyte length and (2) enthesophyte–humeral distance. Acromial morphology was also determined. Interobserver and intraobserver agreement was determined using intraclass correlation and kappa statistical methods.

Results 
The interobserver reliability was fair to moderate and the intraobserver reliability moderate for determining the presence of an acromial enthesophyte. The measurement of the enthesophyte length showed poor interobserver and intraobserver reliability. The measurement of the enthesophyte–humeral distance showed poor interobserver reliability and moderate intraobserver reliability. The interobserver and intraobserver reliability in determining acromial morphology was found to be moderate and good, respectively.

Conclusions 
There is fair to moderate reliability among fellowship-trained shoulder surgeons in determining the presence of an acromial enthesophyte. However, there is poor reliability among observers in measuring the size of the enthesophyte. This study suggests that the enthesophyte–humeral distance may be more reliable than the enthesophyte length when measuring the size of the enthesophyte.

This article appears in HSS Journal: Volume 7, Number 3.
View the full article at springerlink.com.

About the HSS Journal

HSS Journal, an academic peer-reviewed journal, is published twice a year, February and September, and features articles by internal faculty and HSS alumni that present current research and clinical work in the field of musculoskeletal medicine performed at HSS, including research articles, surgical procedures, and case reports.


^ Back to Top
Request an Appointment