Clinics in Shoulder and Elbow

Korean Shoulder and Elbow Society (대한견·주관절의학회)
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Interobserver agreement for detecting Hill-Sachs lesions on magnetic resonance imaging

  • Alkaduhimi, Hassanin (Shoulder and Elbow Unit, Joint Research, OLVG Hospital) ;
  • Saarig, Aimane (Shoulder and Elbow Unit, Joint Research, OLVG Hospital) ;
  • Amajjar, Ihsan (Shoulder and Elbow Unit, Joint Research, OLVG Hospital) ;
  • van der Linde, Just A. (Department of Orthopedic Surgery and Traumatology, Reinier Haga Orthopedisch Centrum) ;
  • van Wier, Marieke F. (Shoulder and Elbow Unit, Joint Research, OLVG Hospital) ;
  • Willigenburg, Nienke W. (Shoulder and Elbow Unit, Joint Research, OLVG Hospital) ;
  • van den Bekerom, Michel P.J. (Shoulder and Elbow Unit, Joint Research, OLVG Hospital)
  • Received : 2021.03.10
  • Accepted : 2021.04.27
  • Published : 2021.06.01
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Abstract

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.

Keywords

Acknowledgement

Shoulder and Elbow Center (collaborators): Gregory R. Waryasz; Matthijs R. Krijnen; Pierre Mansat; Sven A.F. Tulner; Christian M. Fortanier; Carola F. van Eck; Ruud P. van Hove; Christiaan J.A. van Bergen; John N. Trantalis; Paul Hoogervorst; Tjarco D.W. Alta; Guus J.M. Janus; Alexander van Tongel; Diederik J.W. Meijer; Ronald N. Wessel; Mark Schnetzke; John Cheung; Derek F.P. van Deurzen.

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