Pijls B G, Kok F P, Penning L I F, Guldemond N A, Arens H J
Department of Orthopaedic Surgery and Traumatology, Elkerliek Hospital, Helmond, The Netherlands.
J Clin Ultrasound. 2010 Mar-Apr;38(3):128-34. doi: 10.1002/jcu.20674.
The purpose of this study was to evaluate the inter- and intra-observer reliability and accuracy of sonographic (US) acromiohumeral distance (AHD) measurement for both experienced and novice operators in US in patients suffering from subacromial impingement syndrome.
A total of 43 patients (50 shoulders) diagnosed with subacromial impingement syndrome were recruited from an orthopedic outpatient clinic. The US measurement of AHD was obtained consecutively in a neutral position and in a 60 degrees abduction position. A total of 300 blinded measurements were taken.
In the neutral abduction group the intra- observer interclass correlation coefficient (ICC) was 0.94 for the experienced operator and 0.92 for the novice operator. The inter-observer ICC was 0.70 and the accuracy was 1.1 mm. In the 60 degrees abduction group, the intra-observer ICC was 0.90 for the experienced operator and 0.87 for the novice operator. The inter-observer ICC was 0.64 and the accuracy was 1.4 mm. All ICCs were significant at a level of p < 0.0001.
The inaccuracy of the method was 1 mm regardless of the experience of the observer. US AHD measurement in patients with shoulder complaints is not as accurate as reported in healthy subjects. This may have important implications for the clinical use of this parameter.
本研究的目的是评估超声（US）测量肩峰肱骨头距离（AHD）在肩峰下撞击综合征患者中，对于经验丰富和新手超声操作者的观察者间及观察者内可靠性和准确性。
从骨科门诊招募了43例（50个肩部）诊断为肩峰下撞击综合征的患者。在中立位和外展60度位连续进行AHD的超声测量。共进行了300次盲法测量。
在中立外展位组，经验丰富的操作者观察者内组间相关系数（ICC）为0.94，新手操作者为0.92。观察者间ICC为0.70，准确性为1.1毫米。在60度外展位组，经验丰富的操作者观察者内ICC为0.90，新手操作者为0.87。观察者间ICC为0.64，准确性为1.4毫米。所有ICC在p < 0.0001水平均具有显著性。
无论观察者的经验如何，该方法的不准确性为1毫米。肩部有症状患者的超声AHD测量不如健康受试者中报道的准确。这可能对该参数的临床应用具有重要意义。
