title: Interrater and intrarater reliability of lumbar spine magnetic resonance assessment of military aircraft pilot candidates.
abstract: BACKGROUND
  The development of diagnostic imaging facilitates evaluation of spinal anatomy, but there is no full correspondence between morphologic and pathologic changes observed in radiographic studies and clinical findings. The aim of the study was to: 1. Evaluate the degree of signal intensity and degenerative changes of intervertebral discs in the lumbar spine on MRI. 2. Estimate interrater reliability of classification of pathology between experienced and inexperienced medical doctors.
  
  
  METHODS
  The sample consisted of 89 persons aged between 18 and 21 years. MRI scans of the lumbar spine were evaluated by the use of a console for digital analysis by three medical doctors with different levels of experience.
  
  
  RESULTS
  Evidence of dehydration of intervertebral disc was found in 3.37%-4.49% at the L4-L5 level, and in 13.48%-15.73% of cases at the L5-S1 level. Interrater reliability ranged from full agreement at levels where degenerative changes are rarely observed to fair and poor agreement at L4-L5 and L5-S1. Intrarater reliability showed full agreement on higher levels to good and very good at l4-l5 and l5-S1 levels. Interrater reliability concerning the degree of degenerative changes was 0.6 for Th12 to L4, but was poor at L4-L5 and L5-S1. Intrarater reliability ranged from full agreement at higher levels to poor at L3-L4-L5 and moderate at L5-S1.
  
  
  CONCLUSIONS
  1. Asymptomatic intervertebral disk changes were found in 30% of the study participants. 2. Evaluation of the degree of degenerative changes of intervertebral discs requires specialist training and experience.
authors.affiliation: Professor Adam Gruca Teaching Hospital in Otwock, Poland.
authors.forename: Aleksandra
authors.initials: A
authors.lastname: Truszczyńska
authors.forename: Adrian
authors.initials: A
authors.lastname: Brychcy
authors.forename: Kazimierz
authors.initials: K
authors.lastname: Rąpała
authors.forename: Piotr
authors.initials: P
authors.lastname: Walczak
authors.forename: Olaf
authors.initials: O
authors.lastname: Truszczyński
authors.forename: Adam
authors.initials: A
authors.lastname: Tarnowski
mesh_terms: D000293:Adolescent; D000401:Aircraft; D005260:Female; D006801:Humans; D055959:Intervertebral Disc Degeneration / Q000175:diagnosis*; D008159:Lumbar Vertebrae; D008279:Magnetic Resonance Imaging; D008297:Male; D008889:Military Personnel; D015588:Observer Variation; D015203:Reproducibility of Results; D055815:Young Adult