Are radiographic trochanteric surface irregularities associated with abductor tendon abnormalities?
OBJECTIVE
To assess the association between trochanteric surface irregularities seen on conventional radiographs and magnetic resonance (MR) evidence of abductor tendon abnormalities.


METHODS
A total of 150 consecutive patients were evaluated in this retrospective study (age range, 21-88 years; mean age, 58.7 years ± 16.1 [standard deviation]; 57 men, 93 women). Because patients' rights are protected by a procedure in which they are asked to provide general approval for their records and images to be reviewed for scientific purposes, specific approval by the institutional review board was not required. Two readers independently analyzed conventional radiographs and MR images of the hip. Trochanteric surface was graded on conventional radiographs as normal, osseous irregularities extending 1-2 mm, or osseous irregularities extending more than 2 mm. On MR images, the gluteus minimus and gluteus medius tendons were classified as normal or as having tendinopathy or a partial- or full-thickness tear. Logistic regression analysis and the Fisher exact test were used for statistical analysis. Sensitivity, specificity, accuracy, positive and negative predictive values, and positive likelihood ratio were calculated. To assess interobserver agreement, a κ statistic was used.


RESULTS
The positive predictive value of surface irregularities larger than 2 mm for MR tendinopathy or a partial- or full-thickness tear was 90% (37 of 41 patients). The sensitivity of radiographic changes was 40%; the specificity, 94%; the accuracy, 61%; the negative predictive value, 49%; and the positive likelihood ratio, 5.8. Interobserver agreement for detection of trochanteric surface irregularities on conventional radiographs ranged from 0.28 to 0.76.


CONCLUSIONS
Pronounced (>2 mm) surface irregularities of the greater trochanter on conventional radiographs were associated with abductor tendon MR abnormalities.
Steinert
Lenca
L
Department of Radiology, Orthopedic University Hospital Balgrist, Forchstrasse 340, Zurich 8008, Switzerland.
Zanetti
Marco
M
Hodler
Juerg
J
Pfirrmann
Christian W A
CW
Dora
Claudio
C
Saupe
Nadja
N
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005269:Femur / Q000000981:diagnostic imaging / Q000473:pathology*; D006621:Hip Joint / Q000000981:diagnostic imaging / Q000473:pathology*; D006801:Humans; D016015:Logistic Models; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011859:Radiography; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D013499:Surface Properties; D052256:Tendinopathy / Q000000981:diagnostic imaging / Q000473:pathology*