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Comparison of dynamic ultrasound and stress radiology for assessment of inferior glenohumeral laxity in asymptomatic shoulders

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Abstract

Objective

To determine the level of agreement between dynamic ultrasound imaging and stress radiography used for the measurement of inferior glenohumeral laxity in asymptomatic shoulders, and to determine the repeatability of the dynamic ultrasound technique.

Materials and methods

Using a custom-made stress device to apply an inferior displacement force of 90 N, we assessed 20 asymptomatic male subjects for inferior glenohumeral laxity, using stress radiography and dynamic ultrasound. Paired differences between the two methods were evaluated by the 95% limits of agreement method. At a separate session, 19 subjects had inferior glenohumeral laxity assessed by two observers, using dynamic ultrasound. Inter- and intra-observer repeatability was determined for the ultrasound technique.

Results

The mean [(± standard deviation (SD)] inferior translation was 4.7 ± 4.1 mm by stress radiography and 4.4 ± 2.3 mm by dynamic ultrasound. The 95% limits of agreement showed good agreement between the two methods. The paired difference between the two measurement methods varied with the magnitude of the measurement (P < 0.001). Intra-observer repeatability of dynamic ultrasound was determined by the use of intra-class correlation coefficients and was 0.94 and 0.89 for the two investigators. Inter-observer repeatability was 0.85. The standard error of the measurement was 0.60 mm and 0.66 mm, for repeated measurements by the two investigators, and 0.85 mm between investigators. Repeatability coefficients demonstrated excellent consistency of measurement between sessions and good consistency between observers.

Conclusion

Dynamic ultrasound is a valid and reproducible method for the assessment and quantification of inferior glenohumeral laxity.

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Authors and Affiliations

  1. Department of Orthopaedic & Accident Surgery, Queen’s Medical Centre Campus, Nottingham University Hospitals NHS Trust, Nottingham, UK

    S. C. Cheng & W. A. Wallace

  2. Centre for Sports Medicine, Queen’s Medical Centre Campus, University of Nottingham, Nottingham, UK

    D. Hulse

  3. Department of Radiology, City Hospital Campus, Nottingham University Hospitals NHS Trust, Nottingham, NG5 1PB, UK

    K. J. Fairbairn & M. Clarke

Authors
  1. S. C. Cheng
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  2. D. Hulse
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  3. K. J. Fairbairn
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  4. M. Clarke
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  5. W. A. Wallace
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Corresponding author

Correspondence to K. J. Fairbairn.

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Cheng, S.C., Hulse, D., Fairbairn, K.J. et al. Comparison of dynamic ultrasound and stress radiology for assessment of inferior glenohumeral laxity in asymptomatic shoulders. Skeletal Radiol 37, 161–168 (2008). https://doi.org/10.1007/s00256-007-0401-8

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  • DOI: https://doi.org/10.1007/s00256-007-0401-8

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