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Observer variability in the assessment of the acromiohumeral interval using anteroposterior shoulder radiographs

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European Journal of Orthopaedic Surgery & Traumatology Aims and scope Submit manuscript

Abstract

Background

An acromiohumeral interval narrower than 6 mm measured on AP shoulder radiographs has been considered pathological and suggestive of rotator cuff tears. This prospective study was conducted to assess inter- and intraobserver variation in the radiographic assessment of the acromiohumeral interval and its critical value on routinely taken AP shoulder radiographs off-study use to evaluate the accuracy of this measurement method.

Methods

The acromiohumeral distance from the inferior anterior acromial aspect to the humeral head was measured in millimeters. Thirty blinded, anteroposterior shoulder radiographs were independently reviewed by five board-certified orthopedic shoulder surgeons at two time points in random order.

Results

The results of three investigators showed significant intraobserver variation. Five investigator pairs showed significant interobserver variation at both examination time points. The maximum interobserver difference for the same radiograph was 8 mm (range 0 to 8 mm).

Conclusion

Our results indicate that the assessment of the acromiohumeral interval using non-standardized anteroposterior radiographs off-study use cannot be seen as a reproducible and reliable method of measurement.

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Authors and Affiliations

  1. Division of General Surgery, Department of Surgery, Medical University of Graz, Auenbruggerplatz 29, 8036, Graz, Austria

    G. A. Bernhardt

  2. Department of Surgery, District Hospital of Voitsberg, Conrad von Hötzendorfstraße 31, 8570, Voitsberg, Austria

    G. A. Bernhardt

  3. Department of Orthopedic Surgery, Medical University of Graz, Auenbruggerplatz 5-7, 8036, Graz, Austria

    M. Glehr, M. Zacherl & G. Gruber

  4. Orthopedic Hospital Speising, Speisinger Strasse 109, 1130, Vienna, Austria

    C. Wurnig

Authors
  1. G. A. Bernhardt
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  2. M. Glehr
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  3. M. Zacherl
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  4. C. Wurnig
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  5. G. Gruber
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Correspondence to G. A. Bernhardt.

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Bernhardt, G.A., Glehr, M., Zacherl, M. et al. Observer variability in the assessment of the acromiohumeral interval using anteroposterior shoulder radiographs. Eur J Orthop Surg Traumatol 23, 185–190 (2013). https://doi.org/10.1007/s00590-012-0942-y

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  • DOI: https://doi.org/10.1007/s00590-012-0942-y

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