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Skeletal Radiology

, Volume 47, Issue 9, pp 1245–1251 | Cite as

Radiological glenohumeral osteoarthritis in long-term type 1 diabetes. Prevalence and reliability of three classification systems. The Dialong shoulder study

  • Niels Gunnar JuelEmail author
  • Jens I. Brox
  • Johan C. Hellund
  • Else Merckoll
  • Kristine B. Holte
  • Tore J. Berg
Scientific Article

Abstract

Objective

In the present study, we evaluate the intra- and interrater agreement of radiological glenohumeral OA using three different classification systems and estimate the prevalence of radiological and clinical glenohumeral OA in patients with type 1 diabetes mellitus (DM1), for over 45 years and controls (The Dialong study).

Materials and methods

We included 102 patients with DM1 (49% women, mean age, 61.9 years) and 73 controls (57% women, mean age, 62.6 years). Anterior-posterior shoulder radiographs were interpreted by two observers applying the Kellgren–Lawrence (K–L), Samilson–Prieto (S–P) and Samilson–Prieto Allain (S–PA) classifications.

Results

The interrater agreement was moderate (weighted kappa, 0.46 to 0.48) for all classifications and the intrarater agreement mainly substantial (0.48–0.86) for both observers. The agreed prevalence of radiological OA was 26 and 18% (OR 1.6 (0.8 to 3.3), p = 0.22, 44 and 26% (OR 2.2 (1.2 to 4.2), p = 0.02) and 30 and 17% (OR 2.1 (1.0 to 4.5), p = 0.05) for the K–L, S–P and S–PA classifications respectively in the diabetes and control groups. The prevalence of moderate or severe radiological OA was 1 to 6% and clinical OA 1 to 2% with no difference between the groups.

Conclusion

The prevalence of radiological glenohumeral OA was higher in the diabetes group with the Samilson–Prieto classification systems, but not associated with clinical OA. The interrater agreement was moderate. We recommend the Samilson–Prieto Allain classification for glenohumeral OA to avoid interpretation of osteophytes < 1 mm as OA in patient groups with a low pre-test likelihood of glenohumeral OA.

Keywords

Shoulder Type 1 diabetes Glenohumeral osteoarthrosis Kellgren–Lawrence classification Samilson–Prieto classification Frozen shoulder HbA1c 

Notes

Acknowledgements

The authors would like to acknowledge the staff at the radiological department for all essential help in making this manuscript possible.

Compliance with ethical standards

Competing interest

The authors declare that they have no conflicts of interest.

References

  1. 1.
    Louati K, Vidal C, Berenbaum F, Sellam J. Association between diabetes mellitus and osteoarthritis: systematic literature review and meta-analysis. RMD Open. 2015;1(1):e000077.CrossRefPubMedPubMedCentralGoogle Scholar
  2. 2.
    Cho HJ, Morey V, Kang JY, Kim KW, Kim TK. Prevalence and risk factors of spine, shoulder, hand, hip, and knee osteoarthritis in community-dwelling Koreans older than age 65 years. Clin Orthop Relat Res. 2015;473(10):3307–14.CrossRefPubMedPubMedCentralGoogle Scholar
  3. 3.
    Kellgren JH, Lawrence JS. Radiological assessment of osteo-arthrosis. Ann Rheum Dis. 1957;16(4):494–502.CrossRefPubMedPubMedCentralGoogle Scholar
  4. 4.
    Oh JH, Chung SW, Oh CH, Kim SH, Park SJ, Kim KW, et al. The prevalence of shoulder osteoarthritis in the elderly Korean population: association with risk factors and function. J Shoulder Elb Surg. 2011;20(5):756–63.CrossRefGoogle Scholar
  5. 5.
    Kobayashi T, Takagishi K, Shitara H, Ichinose T, Shimoyama D, Yamamoto A, et al. Prevalence of and risk factors for shoulder osteoarthritis in Japanese middle-aged and elderly populations. J Shoulder Elb Surg. 2014;23(5):613–9.CrossRefGoogle Scholar
  6. 6.
    Samilson RL, Prieto V. Dislocation arthropathy of the shoulder. J Bone Joint Surg Am. 1983;65(4):456–60.CrossRefPubMedGoogle Scholar
  7. 7.
    Elsharkawi M, Cakir B, Reichel H, Kappe T. Reliability of radiologic glenohumeral osteoarthritis classifications. J Shoulder Elb Surg. 2013;22(8):1063–7.CrossRefGoogle Scholar
  8. 8.
    Petersson IF, Boegard T, Saxne T, Silman AJ, Svensson B. Radiographic osteoarthritis of the knee classified by the Ahlback and Kellgren & Lawrence systems for the tibiofemoral joint in people aged 35-54 years with chronic knee pain. Ann Rheum Dis. 1997;56(8):493–6.CrossRefPubMedPubMedCentralGoogle Scholar
  9. 9.
    Hamada K, Yamanaka K, Uchiyama Y, Mikasa T, Mikasa M. A radiographic classification of massive rotator cuff tear arthritis. Clin Orthop Relat Res. 2011;469(9):2452–60.CrossRefPubMedPubMedCentralGoogle Scholar
  10. 10.
    Weinstein DM, Bucchieri JS, Pollock RG, Flatow EL, Bigliani LU. Arthroscopic debridement of the shoulder for osteoarthritis. Arthroscopy. 2000;16(5):471–6.CrossRefPubMedGoogle Scholar
  11. 11.
    Brox JI, Lereim P, Merckoll E, Finnanger AM. Radiographic classification of glenohumeral arthrosis. Acta Orthop Scand. 2003;74(2):186–9.CrossRefPubMedGoogle Scholar
  12. 12.
    Magnusson K, Bech Holte K, Juel NG, Brox JI, Hagen KB, Haugen IK, et al. Long-term type 1 diabetes is associated with hand pain, disability and stiffness but not with structural hand osteoarthritis features - the Dialong hand study. PLoS One. 2017;12(5):e0177118.CrossRefPubMedPubMedCentralGoogle Scholar
  13. 13.
    Magnusson K, Slatkowsky-Christensen B, van der Heijde D, Kvien TK, Hagen KB, Haugen IK. Body mass index and progressive hand osteoarthritis: Data from the Oslo hand osteoarthritis cohort. Scand J Rheumatol. 2015;44(4):331–6.CrossRefPubMedGoogle Scholar
  14. 14.
    Ilg A, Bankes MJ, Emery RJ. The intra- and inter-observer reliability of the Samilson and Prieto grading system of glenohumeral arthropathy. Knee Surg Sports Traumatol Arthrosc. 2001;9(3):187–90.CrossRefPubMedGoogle Scholar
  15. 15.
    Allain J, Goutallier D, Glorion C. Long-term results of the Latarjet procedure for the treatment of anterior instability of the shoulder. J Bone Joint Surg Am. 1998;80(6):841–52.CrossRefPubMedGoogle Scholar
  16. 16.
    Englund M, Guermazi A, Gale D, Hunter DJ, Aliabadi P, Clancy M, et al. Incidental meniscal findings on knee MRI in middle-aged and elderly persons. N Engl J Med. 2008;359(11):1108–15.CrossRefPubMedPubMedCentralGoogle Scholar
  17. 17.
    Brinjikji W, Diehn FE, Jarvik JG, Carr CM, Kallmes DF, Murad MH, et al. MRI findings of disc degeneration are more prevalent in adults with low back pain than in asymptomatic controls: A systematic review and meta-analysis. AJNR Am J Neuroradiol. 2015;36(12):2394–9.CrossRefPubMedGoogle Scholar
  18. 18.
    Altman R, Asch E, Bloch D, Bole G, Borenstein D, Brandt K, et al. Development of criteria for the classification and reporting of osteoarthritis. Classification of osteoarthritis of the knee. Diagnostic and therapeutic criteria Committee of the American Rheumatism Association. Arthritis Rheum. 1986;29(8):1039–49.CrossRefPubMedGoogle Scholar
  19. 19.
    Zhang W, Doherty M, Peat G, Bierma-Zeinstra MA, Arden NK, Bresnihan B, et al. EULAR evidence-based recommendations for the diagnosis of knee osteoarthritis. Ann Rheum Dis. 2010;69(3):483–9.CrossRefPubMedGoogle Scholar
  20. 20.
    Bontrager KL, Lampignano J. Bontrager’s handbook of radiographic positioning and techniques. 8th ed. St. Louis: Mosby; 2013.Google Scholar
  21. 21.
    Kiadaliri AA, Lamm CJ, de Verdier MG, Engstrom G, Turkiewicz A, Lohmander LS, et al. Association of knee pain and different definitions of knee osteoarthritis with health-related quality of life: a population-based cohort study in southern Sweden. Health Qual Life Outcomes. 2016;14(1):121.CrossRefPubMedPubMedCentralGoogle Scholar
  22. 22.
    Zhang Y, Jordan JM. Epidemiology of osteoarthritis. Clin Geriatr Med. 2010;26(3):355–69.CrossRefPubMedPubMedCentralGoogle Scholar
  23. 23.
    Juel NG, Brox JI, Brunborg C, Holte KB, Berg TJ. Very high prevalence of frozen shoulder in patients with type 1 diabetes of >/=45 years' duration: the Dialong shoulder study. Arch Phys Med Rehabil. 2017;98(8):1551–9.CrossRefPubMedGoogle Scholar
  24. 24.
    Juel NG, Brox JI, Hellund JC, Holte KB, Berg TJ. The prevalence of radiological glenohumeral osteoarthritis in long-term type 1 diabetes: the Dialong shoulder study. Scand J Rheumatol. 2017:1–6.Google Scholar
  25. 25.
    McHugh ML. Interrater reliability: the kappa statistic. Biochem Med. 2012;22(3):276–82.CrossRefGoogle Scholar
  26. 26.
    Kircher J, Kuerner K, Morhard M, Krauspe R, Habermeyer P. Age-related joint space narrowing independent of the development of osteoarthritis of the shoulder. Int J Shoulder Surg. 2014;8(4):95–100.CrossRefPubMedPubMedCentralGoogle Scholar
  27. 27.
    Hayashi D, Xu L, Gusenburg J, Roemer FW, Hunter DJ, Li L, et al. Reliability of semiquantitative assessment of osteophytes and subchondral cysts on tomosynthesis images by radiologists with different levels of expertise. Diagn Interv Radiol. 2014;20(4):353–9.CrossRefPubMedPubMedCentralGoogle Scholar
  28. 28.
    King KB, Rosenthal AK. The adverse effects of diabetes on osteoarthritis: update on clinical evidence and molecular mechanisms. Osteoarthr Cartil. 2015;23(6):841–50.CrossRefPubMedPubMedCentralGoogle Scholar

Copyright information

© ISS 2018

Authors and Affiliations

  • Niels Gunnar Juel
    • 1
    • 2
    Email author
  • Jens I. Brox
    • 2
    • 3
  • Johan C. Hellund
    • 4
  • Else Merckoll
    • 4
  • Kristine B. Holte
    • 1
  • Tore J. Berg
    • 1
    • 3
    • 5
  1. 1.Department of Endocrinology, Morbid Obesity and Preventive MedicineOslo University HospitalOsloNorway
  2. 2.Department of Physical Medicine and RehabilitationOslo University HospitalOsloNorway
  3. 3.Institute of Clinical Medicine, Faculty of MedicineUniversity of OsloOsloNorway
  4. 4.Clinic of Radiology and Nuclear medicineOslo University HospitalOsloNorway
  5. 5.The Norwegian Diabetics CenterOsloNorway

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