<abstract xmlns="http://www.w3.org/1999/xhtml">

<sec id="j_raon-2021-0056_s_006">
<h3>Background</h3>
<p>Identifying the location and scale of radiographic changes in elbow bony impingement (EBI) is critical in formulating an appropriate diagnosis and treatment plan for such patients. The purpose of present study was to evaluate the intra-rater and inter-rater reliability of the new radiographic parameters, Anterior Impingement angle (AIa) and Posterior Impingement angle (PIa), for EBI. In addition, to determine if there was a relationship between radiographic parameters and clinical evaluation.</p></sec>
<sec id="j_raon-2021-0056_s_007">
<h3>Patients and methods</h3>
<p>Three raters of different levels of training evaluated the radiographs of 60 patients (30 in EBI group and 30 in normal group) twice, at least 2 weeks apart. Intra-rater and inter-rater reliabilities were calculated by Intraclass Correlation Coefficients (ICC) with 95% confidence intervals. Correlation between radiographic parameters and clinical evaluation was calculated by Pearson correlation coefficient.</p></sec>
<sec id="j_raon-2021-0056_s_008">
<h3>Results</h3>
<p>In both groups, intra-rater and inter-rater reliabilities were substantial. There were no significant differences in reliability between upper-hand expert surgeons and resident for either measurement. Good correlation was observed between impingement arcs and range of motion values.</p></sec>
<sec id="j_raon-2021-0056_s_009">
<h3>Conclusions</h3>
<p>Both AIa and PIa measurements demonstrated substantial intra-rater and inter-rater reliability for normal radiographs and in EBI patients. Good reliability, for either expert surgeons or residents in training, and good correlation between radiographic measurements and manual testing, appoints this method may be easily and reliably used in every day practice.</p></sec></abstract>

Background
Identifying the location and scale of radiographic changes in elbow bony impingement (EBI) is critical in formulating an appropriate diagnosis and treatment plan for such patients. The purpose of present study was to evaluate the intra-rater and inter-rater reliability of the new radiographic parameters, Anterior Impingement angle (AIa) and Posterior Impingement angle (PIa), for EBI. In addition, to determine if there was a relationship between radiographic parameters and clinical evaluation.

Patients and methods
Three raters of different levels of training evaluated the radiographs of 60 patients (30 in EBI group and 30 in normal group) twice, at least 2 weeks apart. Intra-rater and inter-rater reliabilities were calculated by Intraclass Correlation Coefficients (ICC) with 95% confidence intervals. Correlation between radiographic parameters and clinical evaluation was calculated by Pearson correlation coefficient.

Results
In both groups, intra-rater and inter-rater reliabilities were substantial. There were no significant differences in reliability between upper-hand expert surgeons and resident for either measurement. Good correlation was observed between impingement arcs and range of motion values.

Conclusions
Both AIa and PIa measurements demonstrated substantial intra-rater and inter-rater reliability for normal radiographs and in EBI patients. Good reliability, for either expert surgeons or residents in training, and good correlation between radiographic measurements and manual testing, appoints this method may be easily and reliably used in every day practice.

Reliability of new radiographic measurement techniques for elbow bony impingement

Radiology and Oncology

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

Background
Identifying the location and scale of radiographic changes in elbow bony impingement (EBI) is critical in formulating an appropriate diagnosis and...

		Inter-rater reliability^a	Intra-rater reliability for rater 1^a	Intra-rater reliability for rater 2^a	Intra-rater reliability for rater 3^a
EBI group	AIa	0.85 (0.75–0.94)	0.87 (0.75–0.94)	0.87 (0.74–0.94)	0.87 (0.75–0.95)
	PIa	0.84 (0.69–0.92)	0.83 (0.66–0.91)	0.88 (0.76–0.94)	0.85 (0.75–0.93)
NORMAL	AIa	0.87 (0.76–0.94)	0.90 (0.81–0.95)	0.87 (0.74–0.94)	0.87 (0.75–0.95)
group	PIa	0.85 (0.75–0.93)	0.86 (0.73–0.93)	0.86 (0.73–0.93)	0.86 (0.74–0.94)

	EBI group^a	NORMAL group^a	p
Flexion (º)	115 ± 8	139 ± 5	< 0.05
Extension deficit (º)	19 ± 12	0 ± 0	< 0.05
fROM (º)	96 ± 14	139 ± 5	< 0.05
SNC (º)	217 ± 10	170 ± 6	< 0.05
AIa (º)	44 ± 5	20 ± 4	< 0.05
Pia (º)	173 ± 10	150 ± 5	< 0.05

		Surgeon 1 vs. surgeon 2^a	Surgeon 1 vs. resident^a	Surgeon 2 vs. resident^a
EBI group	AIa	0.85 (0.71–0.93)	0.85 (0.74–0.94)	0.86 (078–0.95)
	PIa	0.84 (0.69–0.92)	0.89 (0.79–0.95)	0.87 (0.74–0.94)
NORMAL	AIa	0.87 (0.74–0.94)	0.90 (0.80–0.95)	0.88 (0.77–0.94)
group	PIa	0.85 (0.71–0.93)	0.89 (0.77–0.94)	0.87 (0.760–0.94)

Reliability of new radiographic measurement techniques for elbow bony impingement

Article Category: Research Article

Publicado en línea: 11 feb 2022

Páginas: 32 - 36

Recibido: 19 oct 2021

Aceptado: 10 nov 2021

DOI: https://doi.org/10.2478/raon-2021-0056

© 2022 Uros Meglic, Oskar Zupanc, published by Sciendo

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

Figure 1

Figure 2

Inter-rate r and intra-rater reliabilitiesa

Manual and radiographic measurements

Inter-rater reliability between two upper-hand expert surgeons and one resident