Inter‐ and intraobserver agreement in interpretation of CT features of medial coronoid process disease

Shimizu, Naomi; Warren-Smith, Chris; Langley‐Hobbs, Sorrel; Burton, Neil J.; Kulendra, Elvin; Bradley, Kate; Bowen, Elinor; Holdsworth, Andrew; Parsons, Kevin

doi:10.1111/jsap.12411

Cited by 10 publications

(15 citation statements)

References 32 publications

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“…Agreement was poor for grading subchondral sclerosis, fair to moderate for medial coronoid abnormalities, and moderate for detection of osteophytes. 36 Those findings were similar to the findings of our study. In human elbows, the evaluation of elbow OA from MPRs has been shown to have good to excellent intraobserver and interobserver repeatability, and to be more repeatable than radiographic assessment.…”

Section: Discussionsupporting

confidence: 92%

“…13 Coronoid fragmentation and radioulnar fit are evaluated on transverseplane images, radioulnar and humeroradial fit are evaluated on sagittal-plane images, and radioulnar fit is evaluated on frontal-plane images. 35 In a study 36 in which 8 observers read 84 MPR views of the coronoid process twice, intraobserver and interobserver repeatability of evaluations of abnormalities of the medial coronoid process, osteophytes, and subchondral sclerosis ranged widely from poor to excellent, depending on the parameter evaluated. Agreement was poor for grading subchondral sclerosis, fair to moderate for medial coronoid abnormalities, and moderate for detection of osteophytes.…”

Section: Discussionmentioning

confidence: 99%

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Results of using multiplanar reconstructed CT images for assessing elbow joint osteoarthritis in dogs are consistent with results of radiographic assessment

Shubert

Filliquist

Chou

et al. 2022

ajvr

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OBJECTIVE To compare osteoarthritis scores assigned through radiographic evaluation of 18 anatomic regions in the elbow joint with scores assigned through evaluation of 3-D maximum intensity projection (MIP), 3-D surface rendering (TSR), and multiplanar reconstructed (MPR) CT images, and to evaluate intraobserver and interobserver agreement of radiographic and CT scoring. SAMPLE Radiographic and CT images of 39 elbow joints in 20 dogs. PROCEDURES Images were anonymized and graded independently by 5 observers. One observer graded 12 elbow joints 3 times. Intraobserver consistency and repeatability, interobserver agreement, consistency among methods, and bias between methods were calculated. RESULTS The most severe changes were observed at the proximal aspect of the anconeal process, and the medial and cranial aspects of the medial coronoid process. Intraobserver consistency was moderate or better for 11/16 regions with MIP images, 11/16 regions with TSR images, 17/18 regions with MPR images, and 14/18 regions with radiographic images. Interobserver agreement was moderate or better for 5/16 regions with MIP images, 9/16 regions with TSR images, 12/18 regions with MPR images, and 6/18 regions with radiographic images. Mean scores from CT-based methods were higher than mean radiographic scores. CLINICAL RELEVANCE Assessments of osteoarthritis severity in the elbow joints of dogs obtained by examining radiographic images were generally consistent with assessments obtained by examining CT scans. MPR scores were more consistent and more comparable to radiographic scores than were MIP or TSR scores.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Results of using multiplanar reconstructed CT images for assessing elbow joint osteoarthritis in dogs are consistent with results of radiographic assessment

Shubert

Filliquist

Chou

et al. 2022

ajvr

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“…25 Its accessibility may also be limited in general practice, and in a recent study, inter-observer agreement to detect changes consistent with medial coronoid process disease was estimated fair to moderate, and poor for sclerosis grading. 26 As shown in this study, Campbell test has a good sensitivity. Thereby, the clinician usually has a strong clinical suspicion of medial coronoid process disease, but the disease can be in an early stage with only minor lesion on classic imaging techniques.…”

Section: Discussionmentioning

confidence: 50%

Use of Ultrasonography in Diagnosis of Medial Compartment Disease of the Elbow in Dogs

Jacqmin

Livet

Sonet

et al. 2023

Vet Comp Orthop Traumatol

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Objective The objective of this prospective study was to evaluate the use of ultrasonography in the diagnosis of medial coronoid process disease in unclear cases. Study Design Fifteen elbows (on thirteen dogs) for which radiography and computed tomography did not lead to a clear diagnosis of medial coronoid process disease were included. On each elbow, ultrasonography was performed with a high frequency linear transducer (12–18Hz). Then, arthroscopic examination of the joint was performed by a surgeon who was unaware of ultrasonographic findings to confirm medial coronoid process disease. Results At least one ultrasonographic lesion was detected in 13 out of 15 elbows. The main reported ultrasonographic lesions were joint effusion (10/15 elbows) and an abnormal shape of the medial coronoid process (irregular, ill-defined or fragmented) (9/15). Conclusion Ultrasonography can be a helpful additional diagnostic tool to confirm medial coronoid process disease of the elbow joint before performing arthroscopy in unclear cases. Further studies will be needed to evaluate the use of higher frequency transducers and determine if it could improve the diagnostic value of ultrasonography.

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“…Regardless of a variable sensitivity, radiographic examination is always the first choice for ED screening in practice [ 16 – 18 ]. However, due to both superimposition of the radial head over the medial coronoid process and osteophytes, a correct assessment of the MCP is not always possible [ 19 ]. Furthermore, a tight fit between the ulnar trochlear notch and the humeral condyle complicates the correct diagnosis [ 20 ].…”

Section: Introductionmentioning

confidence: 99%

Comparative evaluation of radiographic and computed tomographic findings in dogs with bilateral medial coronoid disease (MCD) presenting with unilateral forelimb lameness

et al. 2023

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Objectives The purpose of this study was to compare the radiographic and computed tomographic (CT) findings of dogs with diagnosed bilateral medial coronoid disease, which showed clinically only unilateral lameness of the forelimbs. Materials and methods Medical records, including radiographs and CT images of dogs with diagnosed bilateral MCD showing only a unilateral forelimb lameness clinically were reviewed retrospectively. Depending on the gait of each dog we established two groups to investigate their radiographs and CT data comparatively. Group I: affected non-lame limb. Group II: affected lame limb. Several evaluation systems were used to assess which factors are important for clinical decision making and a patient tailored therapeutic plan. Results Data from 84 affected elbow joints (42 dogs) diagnosed with MCD by computed tomography were included. Both the radiological and the CT analysis showed that there are significant differences between Groups I and II. Group I had a lower modified International Elbow Working Group Score (IEWG), the values of the Trochlear notch sclerosis were only slightly deviated, and this group showed less often a dislocation of the fragment compared to group II. Furthermore, the size of the fragment (both the median and the mean value) of the forelimbs from group II was almost twice as big as the one from group I. The following sizes of the fragments were calculated (group I versus (vs.) group II)—median: 0.09 cm2 vs. 0.16 cm2, mean value: 0.112 cm2 vs. 0.202 cm2. It could be shown that a larger fragment is more likely to dislocate than a smaller one. Clinical significance This study provides some evidence towards a better understanding of which diagnostic parameters and findings might be important in clinical decision making. Nevertheless, a “decision tree” for the correct therapy of MCD could not be determined in this study.

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Inter‐ and intraobserver agreement in interpretation of CT features of medial coronoid process disease

Cited by 10 publications

References 32 publications

Results of using multiplanar reconstructed CT images for assessing elbow joint osteoarthritis in dogs are consistent with results of radiographic assessment

Results of using multiplanar reconstructed CT images for assessing elbow joint osteoarthritis in dogs are consistent with results of radiographic assessment

Use of Ultrasonography in Diagnosis of Medial Compartment Disease of the Elbow in Dogs

Comparative evaluation of radiographic and computed tomographic findings in dogs with bilateral medial coronoid disease (MCD) presenting with unilateral forelimb lameness

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