Good inter- and intraobserver reliability for assessment of the slip angle in 77 hip radiographs of children with a slipped capital femoral epiphysis

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T1 - Good inter- and intraobserver reliability for assessment of the slip angle in 77 hip radiographs of children with a slipped capital femoral epiphysis

AU - Herngren, Bengt

AU - Lindell, Mikael

AU - Hågglund, Gunnar

PY - 2018

Y1 - 2018

N2 - Background and purpose — The decision on and the outcome of treatment for a slipped capital femoral epiphysis (SCFE) depend on the severity of the slip. In 2015, web-based registration was introduced into the Swedish Pediatric Orthopedic Quality (SPOQ) register. To determine whether the inclusion of commonly used methods in Sweden for radiographic measurement of SCFE (the calcar femorale [CF] method and the Billing method) is justified, we measured the inter- and intraobserver reliability of these 2 measurements. We also evaluated the internationally more commonly used head-shaft angle (HSA) method. Material and methods — 4 observers with different levels of experience with radiographic measurements analyzed 77 routine preoperative hip radiographs of children with SCFE. Inter- and intraobserver reliability was evaluated. Results — The interobserver reliability analysis for the 4 observers showed for CF an ICC of 0.99 (CI 0.97–0.99) and for Billing an ICC of 0.99 (CI 0.98–0.99). The interobserver reliability analysis for 2 observers showed for HSA an ICC of 0.98 (CI 0.97–0.99). Intraobserver reliability (2 observers) showed a mean difference below 1° for all 3 methods and with a 95% limit of agreement not exceeding ±6.8°. Interpretation — We found good reliability for both intra- and interobserver measurements of all 3 methods used for the assessment of the slip angle on routine preoperative lateral hip radiographs.

AB - Background and purpose — The decision on and the outcome of treatment for a slipped capital femoral epiphysis (SCFE) depend on the severity of the slip. In 2015, web-based registration was introduced into the Swedish Pediatric Orthopedic Quality (SPOQ) register. To determine whether the inclusion of commonly used methods in Sweden for radiographic measurement of SCFE (the calcar femorale [CF] method and the Billing method) is justified, we measured the inter- and intraobserver reliability of these 2 measurements. We also evaluated the internationally more commonly used head-shaft angle (HSA) method. Material and methods — 4 observers with different levels of experience with radiographic measurements analyzed 77 routine preoperative hip radiographs of children with SCFE. Inter- and intraobserver reliability was evaluated. Results — The interobserver reliability analysis for the 4 observers showed for CF an ICC of 0.99 (CI 0.97–0.99) and for Billing an ICC of 0.99 (CI 0.98–0.99). The interobserver reliability analysis for 2 observers showed for HSA an ICC of 0.98 (CI 0.97–0.99). Intraobserver reliability (2 observers) showed a mean difference below 1° for all 3 methods and with a 95% limit of agreement not exceeding ±6.8°. Interpretation — We found good reliability for both intra- and interobserver measurements of all 3 methods used for the assessment of the slip angle on routine preoperative lateral hip radiographs.

UR - http://www.scopus.com/inward/record.url?scp=85037982652&partnerID=8YFLogxK

U2 - 10.1080/17453674.2017.1409941

DO - 10.1080/17453674.2017.1409941

M3 - Article

VL - 89

SP - 217

EP - 221

JO - Acta Orthopaedica

JF - Acta Orthopaedica

SN - 1745-3682

IS - 2

ER -