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.
O'Connor
Philip J
PJ
Department of Clinical Radiology, Leeds Teaching Hospitals Trust, The General Infirmary, Great George Street, LS1 3EX, Leeds, UK.
Grainger
Andrew J
AJ
Morgan
S R
SR
Smith
K L
KL
Waterton
J C
JC
Nash
A F P
AF
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