title: Reliability study of the sonographic measurement of the acromiohumeral distance in symptomatic patients.
abstract: BACKGROUND
  The purpose of this study was to evaluate the inter- and intra-observer reliability and accuracy of sonographic (US) acromiohumeral distance (AHD) measurement for both experienced and novice operators in US in patients suffering from subacromial impingement syndrome.
  
  
  METHODS
  A total of 43 patients (50 shoulders) diagnosed with subacromial impingement syndrome were recruited from an orthopedic outpatient clinic. The US measurement of AHD was obtained consecutively in a neutral position and in a 60 degrees abduction position. A total of 300 blinded measurements were taken.
  
  
  RESULTS
  In the neutral abduction group the intra- observer interclass correlation coefficient (ICC) was 0.94 for the experienced operator and 0.92 for the novice operator. The inter-observer ICC was 0.70 and the accuracy was 1.1 mm. In the 60 degrees abduction group, the intra-observer ICC was 0.90 for the experienced operator and 0.87 for the novice operator. The inter-observer ICC was 0.64 and the accuracy was 1.4 mm. All ICCs were significant at a level of p < 0.0001.
  
  
  CONCLUSIONS
  The inaccuracy of the method was 1 mm regardless of the experience of the observer. US AHD measurement in patients with shoulder complaints is not as accurate as reported in healthy subjects. This may have important implications for the clinical use of this parameter.
authors.affiliation: Department of Orthopaedic Surgery and Traumatology, Elkerliek Hospital, Helmond, The Netherlands.
authors.forename: B G
authors.initials: BG
authors.lastname: Pijls
authors.forename: F P
authors.initials: FP
authors.lastname: Kok
authors.forename: L I F
authors.initials: LI
authors.lastname: Penning
authors.forename: N A
authors.initials: NA
authors.lastname: Guldemond
authors.forename: H J
authors.initials: HJ
authors.lastname: Arens
mesh_terms: D000174:Acromion / Q000000981:diagnostic imaging*; D000328:Adult; D000368:Aged; D001837:Body Weights and Measures / Q000379:methods*; D005260:Female; D006801:Humans; D006811:Humerus / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D015203:Reproducibility of Results; D019534:Shoulder Impingement Syndrome / Q000000981:diagnostic imaging*; D014463:Ultrasonography