Skip to main content
Erschienen in: HSS Journal ® 3/2011

01.10.2011 | Original Article

Reliability of Determining and Measuring Acromial Enthesophytes

verfasst von: Keith M. Baumgarten, MD, James L. Carey, MD, MPH, Joseph A. Abboud, MD, Grant L. Jones, MD, John E. Kuhn, MD, Brian R. Wolf, MD, MS, Robert H. Brophy, MD, Charles L. Cox, MD, Rick W. Wright, MD, Armando F. Vidal, MD, C. Benjamin Ma, MD, Eric C. McCarty, MD, G. Brian Holloway, MD, Edwin E. Spencer Jr, MD, Warren R. Dunn, MD, MPH

Erschienen in: HSS Journal ® | Ausgabe 3/2011

Einloggen, um Zugang zu erhalten

Abstract

Background

Although the reliability of determining acromial morphology has been examined, to date, there has not been an analysis of interobserver and intraobserver reliability on determining the presence and measuring the size of an acromial enthesophyte.

Questions/Purposes

The hypothesis of this study was that there will be poor intraobserver and interobserver reliability in the (1) determination of the presence of an acromial enthesophyte, (2) determination of the size of an acromial enthesophyte, and (3) determination of acromial morphology.

Patients and Methods

Fifteen fellowship-trained orthopedic shoulder surgeons reviewed the radiographs of 15 patients at two different intervals. Measurement of acromial enthesophytes was performed using two techniques: (1) enthesophyte length and (2) enthesophyte–humeral distance. Acromial morphology was also determined. Interobserver and intraobserver agreement was determined using intraclass correlation and kappa statistical methods.

Results

The interobserver reliability was fair to moderate and the intraobserver reliability moderate for determining the presence of an acromial enthesophyte. The measurement of the enthesophyte length showed poor interobserver and intraobserver reliability. The measurement of the enthesophyte–humeral distance showed poor interobserver reliability and moderate intraobserver reliability. The interobserver and intraobserver reliability in determining acromial morphology was found to be moderate and good, respectively.

Conclusions

There is fair to moderate reliability among fellowship-trained shoulder surgeons in determining the presence of an acromial enthesophyte. However, there is poor reliability among observers in measuring the size of the enthesophyte. This study suggests that the enthesophyte–humeral distance may be more reliable than the enthesophyte length when measuring the size of the enthesophyte.
Literatur
1.
Zurück zum Zitat Aoki M, Ishii S, Usui M. The morphology of the acromion and its relationship to rotator cuff impingement. Orthop Trans. 1986;10:228. Aoki M, Ishii S, Usui M. The morphology of the acromion and its relationship to rotator cuff impingement. Orthop Trans. 1986;10:228.
2.
Zurück zum Zitat Banas MP, Miller RJ, Totterman S. Relationship between the lateral acromion angle and rotator cuff disease. J Shoulder Elbow Surg. 1995;4(6):454–461.CrossRef Banas MP, Miller RJ, Totterman S. Relationship between the lateral acromion angle and rotator cuff disease. J Shoulder Elbow Surg. 1995;4(6):454–461.CrossRef
3.
Zurück zum Zitat Bigliani LU, Morrison DS, April EW. The morphology of the acromion and its relationship to rotator cuff tears. Orthop Trans. 1986;10:216. Bigliani LU, Morrison DS, April EW. The morphology of the acromion and its relationship to rotator cuff tears. Orthop Trans. 1986;10:216.
4.
Zurück zum Zitat Bright AS, Torpey B, Magid D, Codd T, McFarland EG. Reliability of radiographic evaluation for acromial morphology. Skeletal Radiol. 1997;26(12):718–721.CrossRef Bright AS, Torpey B, Magid D, Codd T, McFarland EG. Reliability of radiographic evaluation for acromial morphology. Skeletal Radiol. 1997;26(12):718–721.CrossRef
5.
Zurück zum Zitat Chambler AF, Bull AM, Reilly P, Amis AA, Emery RJ. Coracoacromial ligament tension in vivo. J Shoulder Elbow Surg. 2003;12(4):365–367.CrossRef Chambler AF, Bull AM, Reilly P, Amis AA, Emery RJ. Coracoacromial ligament tension in vivo. J Shoulder Elbow Surg. 2003;12(4):365–367.CrossRef
6.
Zurück zum Zitat Chambler AF, Emery RJ. Acromial morphology: the enigma of terminology. Knee Surg Sports Traumatol Arthrosc. 1997;5(4):268–272.CrossRef Chambler AF, Emery RJ. Acromial morphology: the enigma of terminology. Knee Surg Sports Traumatol Arthrosc. 1997;5(4):268–272.CrossRef
7.
Zurück zum Zitat Chambler AF, Pitsillides AA, Emery RJ. Acromial spur formation in patients with rotator cuff tears. J Shoulder Elbow Surg. 2003;12(4):314–321.CrossRef Chambler AF, Pitsillides AA, Emery RJ. Acromial spur formation in patients with rotator cuff tears. J Shoulder Elbow Surg. 2003;12(4):314–321.CrossRef
8.
Zurück zum Zitat Edelson JG. The ‘hooked’ acromion revisited. J Bone Joint Surg Br. 1995;77(2):284–287.CrossRef Edelson JG. The ‘hooked’ acromion revisited. J Bone Joint Surg Br. 1995;77(2):284–287.CrossRef
9.
Zurück zum Zitat Edelson JG, Taitz C. Anatomy of the coraco-acromial arch. Relation to degeneration of the acromion. J Bone Joint Surg Br. 1992;74(4):589–594.CrossRef Edelson JG, Taitz C. Anatomy of the coraco-acromial arch. Relation to degeneration of the acromion. J Bone Joint Surg Br. 1992;74(4):589–594.CrossRef
10.
Zurück zum Zitat Epstein RE, Schweitzer ME, Frieman BG, Fenlin JM, Jr., Mitchell DG. Hooked acromion: prevalence on MR images of painful shoulders. Radiology. 1993;187(2):479–481.CrossRef Epstein RE, Schweitzer ME, Frieman BG, Fenlin JM, Jr., Mitchell DG. Hooked acromion: prevalence on MR images of painful shoulders. Radiology. 1993;187(2):479–481.CrossRef
11.
Zurück zum Zitat Farley TE, Neumann CH, Steinbach LS, Petersen SA. The coracoacromial arch: MR evaluation and correlation with rotator cuff pathology. Skeletal Radiol. 1994;23(8):641–645.CrossRef Farley TE, Neumann CH, Steinbach LS, Petersen SA. The coracoacromial arch: MR evaluation and correlation with rotator cuff pathology. Skeletal Radiol. 1994;23(8):641–645.CrossRef
12.
Zurück zum Zitat Fealy S, April EW, Khazzam M, Armengol-Barallat J, Bigliani LU. The coracoacromial ligament: morphology and study of acromial enthesopathy. J Shoulder Elbow Surg. 2005;14(5):542–548.CrossRef Fealy S, April EW, Khazzam M, Armengol-Barallat J, Bigliani LU. The coracoacromial ligament: morphology and study of acromial enthesopathy. J Shoulder Elbow Surg. 2005;14(5):542–548.CrossRef
13.
Zurück zum Zitat Fleiss J. Statistical methods for rates and proportions, 2nd edition. New York: Wiley; 1981. Fleiss J. Statistical methods for rates and proportions, 2nd edition. New York: Wiley; 1981.
14.
Zurück zum Zitat Getz JD, Recht MP, Piraino DW, Schils JP, Latimer BM, Jellema LM, et al. Acromial morphology: relation to sex, age, symmetry, and subacromial enthesophytes. Radiology. 1996;199(3):737–742.CrossRef Getz JD, Recht MP, Piraino DW, Schils JP, Latimer BM, Jellema LM, et al. Acromial morphology: relation to sex, age, symmetry, and subacromial enthesophytes. Radiology. 1996;199(3):737–742.CrossRef
15.
Zurück zum Zitat Gill TJ, McIrvin E, Kocher MS, Homa K, Mair SD, Hawkins RJ. The relative importance of acromial morphology and age with respect to rotator cuff pathology. J Shoulder Elbow Surg. 2002;11(4):327–330.CrossRef Gill TJ, McIrvin E, Kocher MS, Homa K, Mair SD, Hawkins RJ. The relative importance of acromial morphology and age with respect to rotator cuff pathology. J Shoulder Elbow Surg. 2002;11(4):327–330.CrossRef
16.
Zurück zum Zitat Graves WW. Observation on ages changes in the scapula. Am j Phys Anthrop. 1922;5:21–34.CrossRef Graves WW. Observation on ages changes in the scapula. Am j Phys Anthrop. 1922;5:21–34.CrossRef
17.
Zurück zum Zitat Haygood TM, Langlotz CP, Kneeland JB, Iannotti JP, Williams GR, Jr., Dalinka MK. Categorization of acromial shape: interobserver variability with MR imaging and conventional radiography. AJR Am J Roentgenol. 1994;162(6):1377–1382.CrossRef Haygood TM, Langlotz CP, Kneeland JB, Iannotti JP, Williams GR, Jr., Dalinka MK. Categorization of acromial shape: interobserver variability with MR imaging and conventional radiography. AJR Am J Roentgenol. 1994;162(6):1377–1382.CrossRef
18.
Zurück zum Zitat Hirano M, Ide J, Takagi K. Acromial shapes and extension of rotator cuff tears: magnetic resonance imaging evaluation. J Shoulder Elbow Surg. 2002;11(6):576–578.CrossRef Hirano M, Ide J, Takagi K. Acromial shapes and extension of rotator cuff tears: magnetic resonance imaging evaluation. J Shoulder Elbow Surg. 2002;11(6):576–578.CrossRef
19.
Zurück zum Zitat Jacobson SR, Speer KP, Moor JT, Janda DH, Saddemi SR, MacDonald PB, et al. Reliability of radiographic assessment of acromial morphology. J Shoulder Elbow Surg. 1995;4(6):449–453.CrossRef Jacobson SR, Speer KP, Moor JT, Janda DH, Saddemi SR, MacDonald PB, et al. Reliability of radiographic assessment of acromial morphology. J Shoulder Elbow Surg. 1995;4(6):449–453.CrossRef
20.
Zurück zum Zitat Karanicolas PJ, Bhandari M, Kreder H, Moroni A, Richardson M, Walter SD, et al. Evaluating agreement: conducting a reliability study. J Bone Joint Surg Am. 2009;91 Suppl 3:99–106.CrossRef Karanicolas PJ, Bhandari M, Kreder H, Moroni A, Richardson M, Walter SD, et al. Evaluating agreement: conducting a reliability study. J Bone Joint Surg Am. 2009;91 Suppl 3:99–106.CrossRef
21.
Zurück zum Zitat Kitay GS, Iannotti JP, Williams GR, Haygood T, Kneeland BJ, Berlin J. Roentgenographic assessment of acromial morphologic condition in rotator cuff impingement syndrome. J Shoulder Elbow Surg. 1995;4(6):441–448.CrossRef Kitay GS, Iannotti JP, Williams GR, Haygood T, Kneeland BJ, Berlin J. Roentgenographic assessment of acromial morphologic condition in rotator cuff impingement syndrome. J Shoulder Elbow Surg. 1995;4(6):441–448.CrossRef
22.
Zurück zum Zitat Kramer M. Undersurface acromial osteophyte or deltoid tendon attachment to the acromion? AJR Am J Roentgenol. 2008;190(6):W376-377; author reply W378.CrossRef Kramer M. Undersurface acromial osteophyte or deltoid tendon attachment to the acromion? AJR Am J Roentgenol. 2008;190(6):W376-377; author reply W378.CrossRef
23.
Zurück zum Zitat Landis JR, Koch GG. The measurement of observer agreement for categorical data. Biometrics. 1977;33(1):159–174.CrossRef Landis JR, Koch GG. The measurement of observer agreement for categorical data. Biometrics. 1977;33(1):159–174.CrossRef
24.
Zurück zum Zitat MacGillivray JD, Fealy S, Potter HG, O’Brien SJ. Multiplanar analysis of acromion morphology. Am J Sports Med. 1998;26(6):836–840.CrossRef MacGillivray JD, Fealy S, Potter HG, O’Brien SJ. Multiplanar analysis of acromion morphology. Am J Sports Med. 1998;26(6):836–840.CrossRef
25.
Zurück zum Zitat Mahakkanukrauh P, Surin P. Prevalence of osteophytes associated with the acromion and acromioclavicular joint. Clin Anat. 2003;16(6):506–510.CrossRef Mahakkanukrauh P, Surin P. Prevalence of osteophytes associated with the acromion and acromioclavicular joint. Clin Anat. 2003;16(6):506–510.CrossRef
26.
Zurück zum Zitat Mayerhoefer ME, Breitenseher MJ, Roposch A, Treitl C, Wurnig C. Comparison of MRI and conventional radiography for assessment of acromial shape. AJR Am J Roentgenol. 2005;184(2):671–675.CrossRef Mayerhoefer ME, Breitenseher MJ, Roposch A, Treitl C, Wurnig C. Comparison of MRI and conventional radiography for assessment of acromial shape. AJR Am J Roentgenol. 2005;184(2):671–675.CrossRef
27.
Zurück zum Zitat Milz S, Jakob J, Buttner A, Tischer T, Putz R, Benjamin M. The structure of the coracoacromial ligament: fibrocartilage differentiation does not necessarily mean pathology. Scand J Med Sci Sports. 2008;18:16–22.CrossRef Milz S, Jakob J, Buttner A, Tischer T, Putz R, Benjamin M. The structure of the coracoacromial ligament: fibrocartilage differentiation does not necessarily mean pathology. Scand J Med Sci Sports. 2008;18:16–22.CrossRef
28.
Zurück zum Zitat Morrison DS, Frogameni AD, Woodworth P. Non-operative treatment of subacromial impingement syndrome. J Bone Joint Surg Am. 1997;79(5):732–737.CrossRef Morrison DS, Frogameni AD, Woodworth P. Non-operative treatment of subacromial impingement syndrome. J Bone Joint Surg Am. 1997;79(5):732–737.CrossRef
29.
Zurück zum Zitat Natsis K, Tsikaras P, Totlis T, Gigis I, Skandalakis P, Appell HJ, et al. Correlation between the four types of acromion and the existence of enthesophytes: a study on 423 dried scapulas and review of the literature. Clin Anat. 2007;20(3):267–272.CrossRef Natsis K, Tsikaras P, Totlis T, Gigis I, Skandalakis P, Appell HJ, et al. Correlation between the four types of acromion and the existence of enthesophytes: a study on 423 dried scapulas and review of the literature. Clin Anat. 2007;20(3):267–272.CrossRef
30.
Zurück zum Zitat Neer CS, 2nd. Anterior acromioplasty for the chronic impingement syndrome in the shoulder: a preliminary report. J Bone Joint Surg Am. 1972;54(1):41–50.CrossRef Neer CS, 2nd. Anterior acromioplasty for the chronic impingement syndrome in the shoulder: a preliminary report. J Bone Joint Surg Am. 1972;54(1):41–50.CrossRef
31.
Zurück zum Zitat Nicholson GP, Goodman DA, Flatow EL, Bigliani LU. The acromion: morphologic condition and age-related changes. A study of 420 scapulas. J Shoulder Elbow Surg. 1996;5(1):1–11.CrossRef Nicholson GP, Goodman DA, Flatow EL, Bigliani LU. The acromion: morphologic condition and age-related changes. A study of 420 scapulas. J Shoulder Elbow Surg. 1996;5(1):1–11.CrossRef
32.
Zurück zum Zitat Ogata S, Uhthoff HK. Acromial enthesopathy and rotator cuff tear. A radiologic and histologic postmortem investigation of the coracoacromial arch. Clin Orthop Relat Res. 1990(254):39–48. Ogata S, Uhthoff HK. Acromial enthesopathy and rotator cuff tear. A radiologic and histologic postmortem investigation of the coracoacromial arch. Clin Orthop Relat Res. 1990(254):39–48.
33.
Zurück zum Zitat Ogawa K, Yoshida A, Inokuchi W, Naniwa T. Acromial spur: relationship to aging and morphologic changes in the rotator cuff. J Shoulder Elbow Surg. 2005;14(6):591–598.CrossRef Ogawa K, Yoshida A, Inokuchi W, Naniwa T. Acromial spur: relationship to aging and morphologic changes in the rotator cuff. J Shoulder Elbow Surg. 2005;14(6):591–598.CrossRef
34.
Zurück zum Zitat Panni AS, Milano G, Lucania L, Fabbriciani C, Logroscino CA. Histological analysis of the coracoacromial arch: correlation between age-related changes and rotator cuff tears. Arthroscopy. 1996;12(5):531–540.CrossRef Panni AS, Milano G, Lucania L, Fabbriciani C, Logroscino CA. Histological analysis of the coracoacromial arch: correlation between age-related changes and rotator cuff tears. Arthroscopy. 1996;12(5):531–540.CrossRef
35.
Zurück zum Zitat Paraskevas G, Tzaveas A, Papaziogas B, Kitsoulis P, Natsis K, Spanidou S. Morphological parameters of the acromion. Folia Morphol (Warsz). 2008;67(4):255–260.PubMed Paraskevas G, Tzaveas A, Papaziogas B, Kitsoulis P, Natsis K, Spanidou S. Morphological parameters of the acromion. Folia Morphol (Warsz). 2008;67(4):255–260.PubMed
36.
Zurück zum Zitat Park TS, Park DW, Kim SI, Kweon TH. Roentgenographic assessment of acromial morphology using supraspinatus outlet radiographs. Arthroscopy. 2001;17(5):496–501.CrossRef Park TS, Park DW, Kim SI, Kweon TH. Roentgenographic assessment of acromial morphology using supraspinatus outlet radiographs. Arthroscopy. 2001;17(5):496–501.CrossRef
37.
Zurück zum Zitat Pearsall AWt, Bonsell S, Heitman RJ, Helms CA, Osbahr D, Speer KP. Radiographic findings associated with symptomatic rotator cuff tears. J Shoulder Elbow Surg. 2003;12(2):122–127.CrossRef Pearsall AWt, Bonsell S, Heitman RJ, Helms CA, Osbahr D, Speer KP. Radiographic findings associated with symptomatic rotator cuff tears. J Shoulder Elbow Surg. 2003;12(2):122–127.CrossRef
38.
Zurück zum Zitat Portney L, Watkins M. Foundations of Clinical Research: Applications to Practice. New Jersey Prentice Hall Health; 2000. Portney L, Watkins M. Foundations of Clinical Research: Applications to Practice. New Jersey Prentice Hall Health; 2000.
39.
Zurück zum Zitat Sangiampong A, Chompoopong S, Sangvichien S, Thongtong P, Wongjittraporn S. The acromial morphology of Thais in relation to gender and age: study in scapular dried bone. J Med Assoc Thai. 2007;90(3):502–507.PubMed Sangiampong A, Chompoopong S, Sangvichien S, Thongtong P, Wongjittraporn S. The acromial morphology of Thais in relation to gender and age: study in scapular dried bone. J Med Assoc Thai. 2007;90(3):502–507.PubMed
40.
Zurück zum Zitat Taheriazam A, Sadatsafavi M, Moayyeri A. Outcome predictors in nonoperative management of newly diagnosed subacromial impingement syndrome: a longitudinal study. MedGenMed. 2005;7(1):63.PubMedPubMedCentral Taheriazam A, Sadatsafavi M, Moayyeri A. Outcome predictors in nonoperative management of newly diagnosed subacromial impingement syndrome: a longitudinal study. MedGenMed. 2005;7(1):63.PubMedPubMedCentral
41.
Zurück zum Zitat Toivonen DA, Tuite MJ, Orwin JF. Acromial structure and tears of the rotator cuff. J Shoulder Elbow Surg. 1995;4(5):376–383.CrossRef Toivonen DA, Tuite MJ, Orwin JF. Acromial structure and tears of the rotator cuff. J Shoulder Elbow Surg. 1995;4(5):376–383.CrossRef
42.
Zurück zum Zitat Wang JC, Horner G, Brown ED, Shapiro MS. The relationship between acromial morphology and conservative treatment of patients with impingement syndrome. Orthopedics. 2000;23(6):557–559.PubMed Wang JC, Horner G, Brown ED, Shapiro MS. The relationship between acromial morphology and conservative treatment of patients with impingement syndrome. Orthopedics. 2000;23(6):557–559.PubMed
43.
Zurück zum Zitat Wang JC, Shapiro MS. Changes in acromial morphology with age. J Shoulder Elbow Surg. 1997;6(1):55–59.CrossRef Wang JC, Shapiro MS. Changes in acromial morphology with age. J Shoulder Elbow Surg. 1997;6(1):55–59.CrossRef
44.
Zurück zum Zitat Zuckerman JD, Kummer FJ, Cuomo F, Greller M. Interobserver reliability of acromial morphology classification: an anatomic study. J Shoulder Elbow Surg. 1997;6(3):286–287.CrossRef Zuckerman JD, Kummer FJ, Cuomo F, Greller M. Interobserver reliability of acromial morphology classification: an anatomic study. J Shoulder Elbow Surg. 1997;6(3):286–287.CrossRef
Metadaten
Titel
Reliability of Determining and Measuring Acromial Enthesophytes
verfasst von
Keith M. Baumgarten, MD
James L. Carey, MD, MPH
Joseph A. Abboud, MD
Grant L. Jones, MD
John E. Kuhn, MD
Brian R. Wolf, MD, MS
Robert H. Brophy, MD
Charles L. Cox, MD
Rick W. Wright, MD
Armando F. Vidal, MD
C. Benjamin Ma, MD
Eric C. McCarty, MD
G. Brian Holloway, MD
Edwin E. Spencer Jr, MD
Warren R. Dunn, MD, MPH
Publikationsdatum
01.10.2011
Verlag
Springer New York
Erschienen in
HSS Journal ® / Ausgabe 3/2011
Print ISSN: 1556-3316
Elektronische ISSN: 1556-3324
DOI
https://doi.org/10.1007/s11420-011-9209-0

Weitere Artikel der Ausgabe 3/2011

HSS Journal ® 3/2011 Zur Ausgabe

Arthropedia

Grundlagenwissen der Arthroskopie und Gelenkchirurgie. Erweitert durch Fallbeispiele, Videos und Abbildungen. 
» Jetzt entdecken

Update Orthopädie und Unfallchirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.