Coste J, Paolaggi J B, Spira A
Department of Rheumatology, Ambroise Paré Hospital, Boulogne, France.
Spine (Phila Pa 1976). 1991 Apr;16(4):426-8. doi: 10.1097/00007632-199104000-00006.
A study was conducted to investigate the variability of interpretation of plain lumbar spine radiographs by rheumatologists in benign low-back pain (LBP). Intra- and interobserver agreement in classifying the presence of primary radiologic abnormalities according to pre-established criteria was assessed by the Kappa statistic in 115 anteroposterior and lateral radiograms. A significant variability of interpretation was observed for many findings often considered important in benign LBP. Particularly, low levels of agreement were observed for apophyseal joint abnormalities. Schmorl's nodes, spondylolysis, and structural deviations. Elaboration and validation of better standardized criteria for the main radiologic abnormalities is needed to improve the reliability of interpretation of lumbar spine radiographs.
一项研究旨在调查风湿病学家对良性下腰痛（LBP）患者腰椎平片解读的变异性。根据既定标准对115张前后位和侧位X线片上原发性放射学异常的存在情况进行分类，通过Kappa统计量评估观察者内和观察者间的一致性。对于许多在良性LBP中通常被认为重要的发现，观察到了显著的解读变异性。特别是，对于关节突关节异常、施莫尔氏结节、椎弓峡部裂和结构偏差，观察到的一致性水平较低。需要制定和验证针对主要放射学异常的更好的标准化标准，以提高腰椎X线片解读的可靠性。
