Radiographic prediction of lunate morphology in Asians using plain radiographic and capitate-triquetrum distance analyses: reliability and compatibility with magnetic resonance arthrography (MRA) findings

Abstract

Background The purpose of this study was to examine the reliability of plain radiographic methods of determining the lunate type and its compatibility with magnetic resonance arthrography (MRA) findings. Methods Plain radiographs of a total of 150 wrists were reviewed by three observers. Lunate types were evaluated using both conventional posteroanterior (PA) radiographic analysis and the capitate-triquetrum distance (CTD) analysis. Cohen kappa and Fleiss kappa statistics were used to estimate intra- and inter-observer reliabilities. Compatibility with the MRA findings, as assessed by each observer, was investigated. Results The overall intra-observer reliability was 0.517 for the analysis and 0.589 for the CTD analysis. The overall inter-observer agreement was 0.448 for the PA radiographic analysis and 0.581 for the CTD analysis. The PA radiographic analysis and MRA findings for the detection of medial lunate facets were compatible in 119 of the 150 patients (79.3%). Twenty-eight (90.3%) of the 31 incompatible wrists had a medial facet on MRA (Type II), which was not detected in the PA radiographic analysis. In the CTD analysis, the results for 27 of 29 Type II lunates (93.1%) and 39 of 45 Type I lunates (86.7%) were compatible with the MRA. Conclusions This study suggests that predicting the lunate type by plain radiographs alone is insufficient, as both radiographic analyses showed moderate intra- and inter-observer reliabilities. Although both radiographic analyses showed good compatibility with the MRA for Type II lunates, clinicians should be alert to undetected medial facets in Type I lunates on PA radiographic analysis.

Interrater and intrarater agreement on heart murmurs

“…There was a clear tendency that raters who had a low agreement with the reference also had low intrarater agreement ( Figure 3 ), which might indicate lower heart auscultation proficiency. Poor reliability, as determined by interrater and intrarater agreement, undermines the predictive value of clinical examinations [ 11 , 24 ]. The agreements found in this study cannot be categorized as poor, but anyway affects the usefulness of heart auscultation for identifying valvular heart disease.…”

Distal Radioulnar Joint Orientation and Lunate Morphology as Protective Factors of Symptomatic Idiopathic Ulnar Impaction Syndrome in Ulnar-Positive Variant Patients

“…All participants were of Asian descent, and wrist MRI was taken in the neutral wrist position. The lunate bones in both groups were classified as type I or II based on plain radiographs and wrist MRI according to Viegas et al 15,16 (►Fig. 2).…”

“…The lunate bones in both groups were classified as type I or II based on plain radiographs and wrist MRI according to Viegas et al 15 16 ( Fig. 2 ).…”

Analysis of Wrist Morphology Through Hamate and Lunate Bone Variations in Anatolian Population Using Plain Radiography

“…In some presented cases, the triquetra-hamatum is located on a flat inclined the capito-lunatum. However, in some individuals, the triquetrohamate-joint is separated from the capitolunate by a concave-facet (Park et al, 2019;Rachunek et al, 2022). Two main types are defined according to the presence of a facet articulating distally with the hamatum bone (Hein et al, 2022).…”