title: Reliability and validity assessment of a glenoid bone loss measurement using the Bernageau profile view in chronic anterior shoulder instability.
abstract: BACKGROUND
  One of the identified risk factors for anterior shoulder instability is bone loss on the anterior-inferior glenoid rim. The aim of our study was to assess intraobserver and interobserver reproducibility of the Bernageau view to estimate glenoid bone loss and validate this radiographic method with computed tomography (CT) scan. The second objective was to find correlation between Bernageau and arthroscopic bone loss measurements.
  
  
  METHODS
  Twenty patients were included retrospectively. Two independent observers evaluated glenoid bone loss with the ratio between glenoid joint surface diameters of the pathologic and healthy shoulders on Bernageau views. Results were compared with CT (gold standard) and arthroscopic measurements. Validity and reliability of Bernageau measurement were assessed with Spearman correlation coefficients (r) and intraclass correlation coefficients (ρ).
  
  
  RESULTS
  The interobserver and intraobserver reliability and the validity of Bernageau measurement compared with the reference test, the CT scan, were all excellent, with a Spearman ρ between 0.56 (P = .0002) and 0.95 (P < .00001) and an intraclass correlation coefficient between 0.82 (P = .0007) and 0.97 (P < .10(-5)). There was no correlation with arthroscopic evaluation.
  
  
  CONCLUSIONS
  The glenoid bone defect measurement on the Bernageau profile view is a valid and reliable method. Furthermore, it is easy to use in current clinical practice. Surgeons can therefore consider it as a tool for preoperative planning, and its use could decrease CT scan indications.
authors.affiliation: Hôpitaux Universitaires Paris Ile-de-France Ouest, AP-HP, Boulogne-Billancourt, France. erwan.pansard@gmail.com
authors.forename: Erwan
authors.initials: E
authors.lastname: Pansard
authors.forename: Shahnaz
authors.initials: S
authors.lastname: Klouche
authors.forename: Nicolas
authors.initials: N
authors.lastname: Billot
authors.forename: Benoit
authors.initials: B
authors.lastname: Rousselin
authors.forename: Tobias Maximilien
authors.initials: TM
authors.lastname: Kraus
authors.forename: Thomas
authors.initials: T
authors.lastname: Bauer
authors.forename: Philippe
authors.initials: P
authors.lastname: Hardy
mesh_terms: D000328:Adult; D001182:Arthroscopy; D001837:Body Weights and Measures; D001862:Bone Resorption / Q000150:complications / Q000175:diagnosis*; D005260:Female; D061165:Glenoid Cavity / Q000000981:diagnostic imaging*; D006801:Humans; D007593:Joint Instability / Q000150:complications / Q000175:diagnosis*; D008297:Male; D015588:Observer Variation; D056888:Patient Positioning; D016059:Range of Motion, Articular; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012785:Shoulder Joint; D014057:Tomography, X-Ray Computed; D055815:Young Adult
keywords: Bernageau; Diagnostic Study; Level III; Nonconsecutive Patients; Shoulder; bone loss; glenoid rim; instability; radiography