Interrater reliability of sonographic examinations of orbital fractures.
OBJECTIVE
The purpose of this study is to determine whether there are statistically significant variations among different observers when examining fractures of the orbital walls.


METHODS
From December 2003 to April 2004, 28 patients with clinically suspected orbital fractures were examined by ultrasound prospectively. The US images of the infra-orbital margins, the orbital floors, the medial and lateral orbital walls of each patient were reexamined by two independent investigators.


RESULTS
Computed tomography revealed fractures of the orbital floor in 28 out of 31 patients (90.3%). The infra-orbital margins showed fractures of 14 of 31 patients (45.2%). The ultrasound examinations of the orbits by the three examiners presented satisfactory correlation regarding sensitivity and specificity. There were no significant differences between investigators. There was good agreement among the ultrasound examiners regarding the infra-orbital margins. This was not the case for the orbital floors.


CONCLUSIONS
If there are clear cut clinical findings ultrasound examination could represent an alternative to computed tomography. If the clinical findings were indeterminate, computed tomography was essential as implicated by this study. Accordingly, further evaluation of ultrasound examinations of fractures of the orbital margins and floors are necessary.
Jank
Siegfried
S
Department of Oral and Maxillofacial Surgery, University of Innsbruck, Maximilianstr. 10, A-6020 Innsbruck, Australia. siegfried.jank@gmx.de
Siegfried
Jank
J
Deibl
Martina
M
Martina
Deibl
D
Strobl
Heinrich
H
Heinrich
Strobl
S
Oberrauch
Andreas
A
Andreas
Oberrauch
O
Nicasi
Alessandro
A
Alessandro
Nicasi
N
Missmann
Martin
M
Martin
Missmann
M
Bodner
Gerd
G
Gerd
Bodner
B
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016009:Chi-Square Distribution; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D009917:Orbital Fractures / Q000000981:diagnostic imaging*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography