title: Tomographic evaluation of Hill-Sachs lesions: is there a correlation between different methods of measurement?
abstract: BACKGROUND
  Several methods are currently available to evaluate and quantify the glenoid or humeral bone loss; however, none is universally accepted, particularly in the case of Hill-Sachs (HS) lesions.
  
  
  OBJECTIVE
  To establish whether there is correlation among different methods of measuring HS lesions, and to investigate the correlation between glenoid bone loss and the various HS lesion measurements and to assess the inter-observer reliability of such measurements.
  
  
  METHODS
  We assessed computed tomography (CT) or arthro-CT scans taken from individuals with recurrent anterior glenohumeral dislocation. The scans were independently assessed by two examiners. The parameters assessed were as follows: HS lesion width and depth on the axial and coronal planes, articular arc loss on the axial plane, and percentage of glenoid bone loss on the sagittal plane.
  
  
  RESULTS
  Scans from 50 shoulders were assessed. The percentage of articular arc loss and HS lesion width on the axial plane were the only measurements that exhibited strong correlation (r = 0.83; P < 0.001). The values of the correlation coefficient corresponding to HS lesion depth on the coronal plane were the lowest. Most of the measurements exhibited moderate correlation. The inter-examiner reliability was good relative to all measurements except for HS lesion width and depth on the coronal plane, for which it was moderate.
  
  
  CONCLUSIONS
  The measurements of articular arc loss and HS lesion width on the axial plane exhibited strong correlation. The inter-examiner reliability relative to articular arc loss, HS lesion width and depth on the axial plane, and glenoid bone loss was good.
authors.affiliation: Shoulder and Elbow Group, Institute of Orthopedics and Traumatology, University of São Paulo (Universidade de São Paulo - USP), São Paulo, Brazil drjorgeassuncao@gmail.com.
authors.forename: Jorge Henrique
authors.initials: JH
authors.lastname: Assunção
authors.affiliation: Shoulder and Elbow Group, Institute of Orthopedics and Traumatology, University of São Paulo (Universidade de São Paulo - USP), São Paulo, Brazil.
authors.forename: Mauro Emilio Conforto
authors.initials: ME
authors.lastname: Gracitelli
authors.affiliation: Shoulder and Elbow Group, Institute of Orthopedics and Traumatology, University of São Paulo (Universidade de São Paulo - USP), São Paulo, Brazil.
authors.forename: Gustavo Dias
authors.initials: GD
authors.lastname: Borgo
authors.affiliation: Shoulder and Elbow Group, Institute of Orthopedics and Traumatology, University of São Paulo (Universidade de São Paulo - USP), São Paulo, Brazil.
authors.forename: Eduardo Angeli
authors.initials: EA
authors.lastname: Malavolta
authors.affiliation: Department of Radiology, Institute of Orthopedics and Traumatology, USP, São Paulo, Brazil.
authors.forename: Marcelo
authors.initials: M
authors.lastname: Bordalo-Rodrigues
authors.affiliation: Shoulder and Elbow Group, Institute of Orthopedics and Traumatology, University of São Paulo (Universidade de São Paulo - USP), São Paulo, Brazil.
authors.forename: Arnaldo Amado
authors.initials: AA
authors.lastname: Ferreira Neto
mesh_terms: D000070896:Bankart Lesions / Q000150:complications / Q000175:diagnosis*; D005260:Female; D061165:Glenoid Cavity / Q000187:drug effects*; D006801:Humans; D008297:Male; D015588:Observer Variation; D056888:Patient Positioning / Q000379:methods*; D011857:Radiographic Image Interpretation, Computer-Assisted / Q000379:methods*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D012783:Shoulder Dislocation / Q000000981:diagnostic imaging* / Q000209:etiology; D013223:Statistics as Topic; D014057:Tomography, X-Ray Computed / Q000379:methods*; D055815:Young Adult
keywords: Hill–Sachs lesion; computed tomography (CT); glenoid; shoulder instability