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KMID : 1036220210240020098
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Clinics in Shoulder and Elbow
2021 Volume.24 No. 2 p.98 ~ p.105
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Interobserver agreement for detecting Hill-Sachs lesions on magnetic resonance imaging
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Alkaduhimi Hassanin
Saarig Aimane
Amajjar Ihsan
van der Linde Just A.
van Wier Marieke F.
van den Bekerom Michel P. J.
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Abstract
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Background: Our aim is to determine the interobserver reliability for surgeons to detect Hill-Sachs lesions on magnetic resonance imaging (MRI), the certainty of judgement, and the effects of surgeon characteristics on agreement.
Methods: Twenty-nine patients with Hill-Sachs lesions or other lesions with a similar appearance on MRIs were presented to 20 surgeons without any patient characteristics. The surgeons answered questions on the presence of Hill-Sachs lesions and the certainty of diagnosis. Interobserver agreement was assessed using the Fleiss’ kappa (κ) and percentage of agreement. Agreement between surgeons was compared using a technique similar to the pairwise t-test for means, based on large-sample linear approximation of Fleiss' kappa, with Bonferroni correction.
Results: The agreement between surgeons in detecting Hill-Sachs lesions on MRI was fair (69% agreement; κ, 0.304; p<0.001). In 84% of the cases, surgeons were certain or highly certain about the presence of a Hill-Sachs lesion.
Conclusions: Although surgeons reported high levels of certainty for their ability to detect Hill-Sachs lesions, there was only a fair amount of agreement between surgeons in detecting Hill-Sachs lesions on MRI. This indicates that clear criteria for defining Hill-Sachs lesions are lacking, which hampers accurate diagnosis and can compromise treatment.
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KEYWORD
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Observer variation, Shoulder, Joint instability, Bankart lesions, Hill-Sachs
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