Agreement of diagnostic ultrasound in shoulder pain
Next to the conventional assessment procedure, including a history taking and physical examination, diagnostic ultrasound is gaining popularity among physiotherapists as a means for diagnosing musculoskeletal disorders more accurately. Orthopedic surgeons and radiologists, however, generally do not see physiotherapists fit to perform diagnostic ultrasounds.
Therefore, this study sought to determine the interrater-reliability of diagnostic ultrasound between physiotherapists and radiologists for full thickness rotator cuff tears in patients, clinically presenting with shoulder pain. Also, the interrater-reliability for partial rotator cuff tears, calcifications and subacromial bursitis was investigated.
Substantial agreement was present for full thickness tears (k = 0.63); there was slight agreement in cases with partial tears, fair agreement on calcifications and moderate agreement was present for subacromial bursitis. Overall agreement was fair (k = 0.36), with a high level of specific negative agreement (86%) indicating that agreement in ruling a pathology out was higher compared to actually diagnosing a pathology.
Noteworthy, more highly-educated and experienced physiotherapists showed a moderate level of agreement with radiologists, suggesting the presence of a learning curve positively affecting diagnostic accuracy. > From: Thoomes-de Graaf et al., Man Ther (2014) (Epub ahead of print). All rights reserved to Elsevier Ltd.