Intra- and interobserver reliabilities of two common radiographic methods of carpal height measurement

  • Alireza SaiedEmail author
  • Afshin Zyaei
Original Article



Carpal height is a radiographic ratio with clinical significance in rheumatologic diseases and Kienbock disease, which is measured with different methods. The purpose of this study is assessment of two popular methods of measurement of this angle with respect to inter- and intraobserver variabilities.

Materials and methods

Good-quality photographs were made of 20 radiograms and two experienced orthopedists, in two separate occasions measured the length of third metacarpal, the longest length of capitate, and the distance between the base of third metacarp to the articular surface of the radius. The remainder of the calculations was made by computer.


Intraobserver reliability of the Youm and Nattrass ratios was calculated as high and fair, respectively. With regard to interobserver reliability, the accuracy of both indices was poor. Intra- and interobserver agreement for detection of collapse of the wrist was substantial for Youm ratio and fair to moderate for Nattrass ratio. The ratios had poor agreement with each other with regard to detection of collapse of the wrist joint.


Although neither of the ratios had perfect or high reliability with regard to the subject of the study, it seems that the accuracy of Youm index is higher.


Carpal height Interobserver reliability Intraobserver reliability 



The authors desire to declare their maximum attitude toward Najde Mazhar F. M.D., orthopedic surgeon, hand surgery fellow, assistant professor of orthopedics, Iran University of Medical Sciences and Nakhaie M. M.D. assistant professor of orthopedics, Iran University of Medical Sciences, for their careful and patient assistance with the measurement of variables of the study and also toward Nakhaie N. M.D. M.P.H., associate professor of Social Medicine Department, Kerman University of Medical Sciences for his skillful statistic analysis of the data.

Conflict of interest statement

No funds were received in support of this study.


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Copyright information

© Springer-Verlag 2009

Authors and Affiliations

  1. 1.Kerman Neuroscience Research Center, Dr. Bahonar HospitalKerman University of Medical SciencesKermanIran
  2. 2.Hormozgan University of Medical SciencesBandar AbbassIran

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