1. Head-at-risk signs in Legg-Calvé-Perthes disease: poor inter- and intra-observer reliability
- Author
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Rohan Rajan, Senthil Kumar, Mark C Forster, W Guy Atherton, Vallipuram R Thava, and Rajan Asirvatham
- Subjects
medicine.medical_specialty ,Pediatrics ,Disease ,Risk Factors ,medicine ,Legg-Calve-Perthes disease ,Humans ,Orthopedics and Sports Medicine ,Growth Plate ,Risk factor ,Child ,Reliability (statistics) ,Observer Variation ,business.industry ,Calcinosis ,Reproducibility of Results ,Femur Head ,General Medicine ,medicine.disease ,Prognosis ,Intra observer ,Radiography ,El Niño ,Orthopedic surgery ,Physical therapy ,Legg-Calve-Perthes Disease ,Surgery ,business ,Observer variation - Abstract
The head-at-risk signs are used as prognostic indicators in Legg-Calvé-Perthes disease. These signs have been assessed only once regarding inter-observer reliability, however. Intra-observer reliability seems not to have been studied to date.76 anteroposterior pelvic radiographs of unilateral Legg-Calvé-Perthes disease were assessed by 5 observers on 2 occasions, in order to assess the inter- and intra-observer reliability in identifying head-at-risk signs. The observers included 1 consultant pediatric orthopaedic surgeon, 1 consultant radiologist, 2 specialist registrars and 1 senior house officer. Inter- and intra-observer reliabilities were assessed using the kappa coefficient.The intra-observer reliability was good for lateral subluxation and metaphyseal cystic changes, moderate for lateral calcification, and fair for Gage's sign and horizontal growth plate. The inter-observer reliability was moderate for lateral subluxation, fair for lateral calcification and metaphyseal cystic changes, and slight for Gage's sign and horizontal growth plate.There was considerable variation in the diagnosis of the head-at-risk signs between observers. This makes the classification difficult to use in clinical practice.
- Published
- 2006