title: Accuracy of internet images of glenoid labral injuries.
abstract: BACKGROUND
  The internet is a convenient source of health information used widely by patients and doctors. Previous studies have found that the written information provided was often inaccurate. There is no literature regarding the accuracy of medical images on the internet. The aim of this study was to assess the accuracy of internet images of injuries to the glenoid labrum following shoulder dislocation.
  
  
  METHODS
  The Google and Bing search engines were used to find images of Bankart, Perthes and anterior labroligamentous periosteal sleeve avulsion (ALPSA) lesions. Three independent reviewers assessed the accuracy of image labelling.
  
  
  RESULTS
  Of images labelled 'Bankart lesion', 30% (9/30) were incorrect while 'Perthes lesion' images were incorrect in 15% of cases (9/60) and 4% of 'ALPSA lesion' images were incorrect (2/46). There was good interobserver reliability (kappa = 0.81). Labelling accuracy was better on educational sites than on commercial sites (6% vs 25% inaccurate, p=0.0013).
  
  
  CONCLUSIONS
  Caution is recommended when interpreting non-peer reviewed images on the internet.
authors.affiliation: Brighton and Sussex University Hospitals NHS Trust, Royal Sussex County Hospital, Eastern Road, Brighton BN2 5BE, UK. richardfreeman@doctors.net.uk.
authors.forename: R
authors.initials: R
authors.lastname: Freeman
authors.forename: F
authors.initials: F
authors.lastname: Ashouri
authors.forename: J
authors.initials: J
authors.lastname: Papanikitas
authors.forename: D
authors.initials: D
authors.lastname: Ricketts
mesh_terms: D061165:Glenoid Cavity / Q000000981:diagnostic imaging / Q000293:injuries* / Q000473:pathology; D006801:Humans; D020407:Internet / Q000592:standards*; D007593:Joint Instability / Q000000981:diagnostic imaging / Q000473:pathology; D008023:Ligaments, Articular / Q000000981:diagnostic imaging / Q000293:injuries* / Q000473:pathology; D008488:Medical Illustration; D015588:Observer Variation; D011859:Radiography; D057386:Search Engine / Q000592:standards*; D012680:Sensitivity and Specificity; D012783:Shoulder Dislocation / Q000000981:diagnostic imaging / Q000473:pathology*
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