Comparison of dynamic ultrasound and stress radiology for assessment of inferior glenohumeral laxity in asymptomatic shoulders |
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Authors: | S C Cheng D Hulse K J Fairbairn M Clarke W A Wallace |
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Institution: | (1) Department of Orthopaedic & Accident Surgery, Queen’s Medical Centre Campus, Nottingham University Hospitals NHS Trust, Nottingham, UK;(2) Centre for Sports Medicine, Queen’s Medical Centre Campus, University of Nottingham, Nottingham, UK;(3) Department of Radiology, City Hospital Campus, Nottingham University Hospitals NHS Trust, Nottingham, NG5 1PB, UK |
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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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Keywords: | Shoulder Ultrasound Translation Radiology |
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