Original Article

HSS Journal

, Volume 7, Issue 3, pp 218-222

Reliability of Determining and Measuring Acromial Enthesophytes

  • Keith M. BaumgartenAffiliated withSports Medicine and Shoulder Surgery Section, Orthopedic Institute Email author 
  • , James L. CareyAffiliated withDepartment of Orthopaedics and Rehabilitation, Vanderbilt University Medical Center
  • , Joseph A. AbboudAffiliated withShoulder and Elbow Service, Department of Orthopaedic Surgery, University of Pennsylvania Health System
  • , Grant L. JonesAffiliated withDepartment of Orthopaedic Surgery, The Ohio State University
  • , John E. KuhnAffiliated withDepartment of Orthopaedics and Rehabilitation, Vanderbilt University Medical Center
  • , Brian R. WolfAffiliated withDepartment of Orthopaedic Surgery, University of Iowa Hospitals and Clinics
  • , Robert H. BrophyAffiliated withDepartment of Orthopaedic Surgery, Washington University School of Medicine
  • , Charles L. CoxAffiliated withDepartment of Orthopaedics and Rehabilitation, Vanderbilt University Medical Center
  • , Rick W. WrightAffiliated withDepartment of Orthopaedic Surgery, Washington University School of Medicine
    • , Armando F. VidalAffiliated withSports Medicine and Shoulder Service, Department of Orthopaedic Surgery, University of Colorado School of Medicine
    • , C. Benjamin MaAffiliated withDepartment of Orthopaedic Surgery, University of California, San Francisco
    • , Eric C. McCartyAffiliated withSports Medicine and Shoulder Surgery Section, Orthopedic InstituteDepartment of Orthopaedic Surgery, University of Colorado School of Medicine
    • , G. Brian HollowayAffiliated withSports Medicine and Shoulder Surgery Section, Orthopedic InstituteShoulder and Elbow Institute, Knoxville Orthopaedic Clinic
    • , Edwin E. SpencerJrAffiliated withSports Medicine and Shoulder Surgery Section, Orthopedic InstituteShoulder and Elbow Institute, Knoxville Orthopaedic Clinic
    • , Warren R. DunnAffiliated withDepartment of Orthopaedics & Rehabilitation, Health Sciences Research Center, Vanderbilt University Medical Center

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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.

Keywords

enthesophyte acromion reliability morphology