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Radiographic classifications in Perthes disease: Interobserver agreement and association with femoral head sphericity at 5-year follow-up
BACKGROUND AND PURPOSE: Different radiographic classifications have been proposed for prediction of outcome in Perthes disease. We assessed whether the modified lateral pillar classification would provide more reliable interobserver agreement and prognostic value compared with the original lateral p...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Taylor & Francis
2017
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5560216/ https://www.ncbi.nlm.nih.gov/pubmed/28613966 http://dx.doi.org/10.1080/17453674.2017.1340040 |
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author | Huhnstock, Stefan Svenningsen, Svein Merckoll, Else Catterall, Anthony Terjesen, Terje Wiig, Ola |
author_facet | Huhnstock, Stefan Svenningsen, Svein Merckoll, Else Catterall, Anthony Terjesen, Terje Wiig, Ola |
author_sort | Huhnstock, Stefan |
collection | PubMed |
description | BACKGROUND AND PURPOSE: Different radiographic classifications have been proposed for prediction of outcome in Perthes disease. We assessed whether the modified lateral pillar classification would provide more reliable interobserver agreement and prognostic value compared with the original lateral pillar classification and the Catterall classification. PATIENTS AND METHODS: 42 patients (38 boys) with Perthes disease were included in the interobserver study. Their mean age at diagnosis was 6.5 (3–11) years. 5 observers classified the radiographs in 2 separate sessions according to the Catterall classification, the original and the modified lateral pillar classifications. Interobserver agreement was analysed using weighted kappa statistics. We assessed the associations between the classifications and femoral head sphericity at 5-year follow-up in 37 non-operatively treated patients in a crosstable analysis (Gamma statistics for ordinal variables, γ). RESULTS: The original lateral pillar and Catterall classifications showed moderate interobserver agreement (kappa 0.49 and 0.43, respectively) while the modified lateral pillar classification had fair agreement (kappa 0.40). The original lateral pillar classification was strongly associated with the 5-year radiographic outcome, with a mean γ correlation coefficient of 0.75 (95% CI: 0.61–0.95) among the 5 observers. The modified lateral pillar and Catterall classifications showed moderate associations (mean γ correlation coefficient 0.55 [95% CI: 0.38–0.66] and 0.64 [95% CI: 0.57–0.72], respectively). INTERPRETATION: The Catterall classification and the original lateral pillar classification had sufficient interobserver agreement and association to late radiographic outcome to be suitable for clinical use. Adding the borderline B/C group did not increase the interobserver agreement or prognostic value of the original lateral pillar classification. |
format | Online Article Text |
id | pubmed-5560216 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | Taylor & Francis |
record_format | MEDLINE/PubMed |
spelling | pubmed-55602162017-10-01 Radiographic classifications in Perthes disease: Interobserver agreement and association with femoral head sphericity at 5-year follow-up Huhnstock, Stefan Svenningsen, Svein Merckoll, Else Catterall, Anthony Terjesen, Terje Wiig, Ola Acta Orthop Hip BACKGROUND AND PURPOSE: Different radiographic classifications have been proposed for prediction of outcome in Perthes disease. We assessed whether the modified lateral pillar classification would provide more reliable interobserver agreement and prognostic value compared with the original lateral pillar classification and the Catterall classification. PATIENTS AND METHODS: 42 patients (38 boys) with Perthes disease were included in the interobserver study. Their mean age at diagnosis was 6.5 (3–11) years. 5 observers classified the radiographs in 2 separate sessions according to the Catterall classification, the original and the modified lateral pillar classifications. Interobserver agreement was analysed using weighted kappa statistics. We assessed the associations between the classifications and femoral head sphericity at 5-year follow-up in 37 non-operatively treated patients in a crosstable analysis (Gamma statistics for ordinal variables, γ). RESULTS: The original lateral pillar and Catterall classifications showed moderate interobserver agreement (kappa 0.49 and 0.43, respectively) while the modified lateral pillar classification had fair agreement (kappa 0.40). The original lateral pillar classification was strongly associated with the 5-year radiographic outcome, with a mean γ correlation coefficient of 0.75 (95% CI: 0.61–0.95) among the 5 observers. The modified lateral pillar and Catterall classifications showed moderate associations (mean γ correlation coefficient 0.55 [95% CI: 0.38–0.66] and 0.64 [95% CI: 0.57–0.72], respectively). INTERPRETATION: The Catterall classification and the original lateral pillar classification had sufficient interobserver agreement and association to late radiographic outcome to be suitable for clinical use. Adding the borderline B/C group did not increase the interobserver agreement or prognostic value of the original lateral pillar classification. Taylor & Francis 2017-10 2017-06-14 /pmc/articles/PMC5560216/ /pubmed/28613966 http://dx.doi.org/10.1080/17453674.2017.1340040 Text en © 2017 The Author(s). Published by Taylor & Francis on behalf of the Nordic Orthopedic Federation. https://creativecommons.org/licenses/by-nc/3.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution-Non-Commercial License (https://creativecommons.org/licenses/by-nc/3.0) |
spellingShingle | Hip Huhnstock, Stefan Svenningsen, Svein Merckoll, Else Catterall, Anthony Terjesen, Terje Wiig, Ola Radiographic classifications in Perthes disease: Interobserver agreement and association with femoral head sphericity at 5-year follow-up |
title | Radiographic classifications in Perthes disease: Interobserver agreement and association with femoral head sphericity at 5-year follow-up |
title_full | Radiographic classifications in Perthes disease: Interobserver agreement and association with femoral head sphericity at 5-year follow-up |
title_fullStr | Radiographic classifications in Perthes disease: Interobserver agreement and association with femoral head sphericity at 5-year follow-up |
title_full_unstemmed | Radiographic classifications in Perthes disease: Interobserver agreement and association with femoral head sphericity at 5-year follow-up |
title_short | Radiographic classifications in Perthes disease: Interobserver agreement and association with femoral head sphericity at 5-year follow-up |
title_sort | radiographic classifications in perthes disease: interobserver agreement and association with femoral head sphericity at 5-year follow-up |
topic | Hip |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5560216/ https://www.ncbi.nlm.nih.gov/pubmed/28613966 http://dx.doi.org/10.1080/17453674.2017.1340040 |
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