Ultrasound assessment of tendons in asymptomatic volunteers: a study of reproducibility.
The purpose was to evaluate the inter-visit, inter-observer and intra-observer variation of quantitative and qualitative tendon examinations in vivo for a cohort of asymptomatic volunteers. Eleven healthy male subjects were recruited. The following tendons were assessed by ultrasonography: Achilles tendon, patellar tendon, triceps tendon, extensor pollicis longus, flexor carpi radialis and supraspinatus. For each tendon a quantitative measurement of tendon size was made at a predefined anatomical location. Two experienced sonologists, blind to one another's findings, evaluated each of the tendons independently. Each tendon was evaluated on two occasions 1 week apart. No difference was found to be attributed to variation in tendon size between visits. Inter-observer variation was a source of error with intra-subject, inter-visit measurements proving more reproducible. There was some significant variation between observers. This variation was more marked with some tendon measures than others. Inter-observer variation for triceps, flexor carpi radialis and supraspinatus was most marked. Minimum detectable change in tendons varied from 13 to 57% depending on the plane of scanning and the tendon being examined. Good reproducibility of quantitative tendon measurements can be achieved within a study using two observers by following a defined scanning protocol. However, it is recommended that the same observer perform serial assessments. The data allow minimal detectable changes in tendon size to be calculated.
Department of Clinical Radiology, Leeds Teaching Hospitals Trust, The General Infirmary, Great George Street, LS1 3EX, Leeds, UK.
Philip J
PJ
O'Connor
Andrew J
AJ
Grainger
S R
SR
Morgan
K L
KL
Smith
J C
JC
Waterton
A F P
AF
Nash
D000328:Adult; D015331:Cohort Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D012016:Reference Values; D015203:Reproducibility of Results; D013710:Tendons / Q000033:anatomy & histology* / Q000000981:diagnostic imaging*; D018608:Ultrasonography, Doppler / Q000379:methods