Physical Medicine and Rehabilitation, Department of Physical Medicine and Rehabilitation, Mayo Clinic College of Medicine and Science, Rochester, MN.
Department of Physical Medicine and Rehabilitation, Mayo Clinic College of Medicine and Science, Rochester, MN.
PM R. 2020 Jan;12(1):26-35. doi: 10.1002/pmrj.12183. Epub 2019 Aug 14.
Ultrasound has become a useful instrument in evaluating musculoskeletal pathology. Recent studies suggest that ultrasound imaging of weight-bearing menisci may enhance the assessment of knee pathology, such as osteoarthritis (OA) and meniscal injuries.
The primary aim of this study was to determine the intrarater and interrater reliability of ultrasound measurements of medial meniscal extrusion (MME) after a brief training session.
Prospective reliability study.
Physical medicine and rehabilitation (PM&R) department within a tertiary care institution.
Forty-five participants (29 female, 16 male) were recruited to serve as models, 24 of whom had healthy knees and 21 of whom had radiographically confirmed medial compartment knee OA. Three physician sonographers (1 = experienced, 1 = sports medicine fellow, 1 = post-graduate year [PGY]-4 PM&R resident) were recruited to serve as operators.
Operators received a brief training session on identifying and measuring MME. All operators measured bilateral MME in each model in the standing and supine positions on two separate days. Operators were blinded to all measurements.
Primary outcomes were inter- and intrarater intraclass correlation coefficients (ICCs) of MME measurements among operators with different levels of ultrasound experience.
Supine MME intrarater reliability ICCs were 0.927, 0.885, and 0.780 for the experienced physician, sports medicine fellow, and PGY-4 operators, respectively. Standing MME intrarater reliability ICCs were 0.941, 0.902, and 0.824 for the experienced physician, sports medicine fellow, and PGY-4 operators, respectively. Interrater reliability ICCs were 0.896 and 0.842 for supine and standing measurements, respectively. There was a statistically significant increase in intrarater reliability with experience between the PGY-4 resident and experienced physician operators.
Operators with different levels of ultrasound experience demonstrated good MME measurement intra- and interrater reliabilities in both supine and standing positions.
超声已成为评估肌肉骨骼系统疾病的有用工具。最近的研究表明，负重半月板的超声成像可能会增强对膝关节疾病（如骨关节炎（OA）和半月板损伤）的评估。
本研究的主要目的是确定经过短暂培训后测量内侧半月板突出（MME）的内部和外部观察者之间的可靠性。
前瞻性可靠性研究。
三级医疗机构的物理医学与康复（PM＆R）部门。
招募了 45 名参与者（29 名女性，16 名男性）作为模型，其中 24 名参与者的膝关节健康，21 名参与者的膝关节有放射学证实的内侧间室 OA。招募了 3 名医师超声医师（1 名=经验丰富，1 名=运动医学研究员，1 名=研究生 [PGY]-4 PM＆R 住院医师）作为操作员。
操作员接受了有关识别和测量 MME 的简短培训。所有操作员在两天内在两个不同的日子分别在站立和仰卧位测量每个模型的双侧 MME。操作员对所有测量均不知情。
主要结果是不同超声经验水平的操作员之间 MME 测量的内部和外部观察者之间的组内相关系数（ICC）。
仰卧位 MME 内部观察者可靠性 ICC 分别为经验丰富的医师、运动医学研究员和 PGY-4 操作员的 0.927、0.885 和 0.780。站立位 MME 内部观察者可靠性 ICC 分别为经验丰富的医师、运动医学研究员和 PGY-4 操作员的 0.941、0.902 和 0.824。仰卧位和站立位的外部观察者可靠性 ICC 分别为 0.896 和 0.842。仰卧位和站立位的外部观察者可靠性 ICC 分别为 0.896 和 0.842。仰卧位和站立位的外部观察者可靠性 ICC 分别为 0.896 和 0.842。仰卧位和站立位的外部观察者可靠性 ICC 分别为 0.896 和 0.842。仰卧位和站立位的外部观察者可靠性 ICC 分别为 0.896 和 0.842。有统计学意义的是，PGY-4 住院医师和经验丰富的医师操作员之间的内部观察者可靠性随经验的增加而增加。
具有不同超声经验水平的操作员在仰卧位和站立位均显示出良好的 MME 测量内部和外部观察者之间的可靠性。
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