The Copenhagen Standardised MRI protocol to assess the pubic symphysis and adductor regions of athletes: outline and intratester and intertester reliability
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The Copenhagen Standardised MRI protocol to assess the pubic symphysis and adductor regions of athletes : outline and intratester and intertester reliability. / Branci, Sonia; Thorborg, Kristian; Bech, Birthe Højlund; Boesen, Mikael; Magnussen, Erland; Court-Payen, Michel; Nielsen, Michael Bachmann; Hölmich, Per.
I: British Journal of Sports Medicine, Bind 49, Nr. 10, 05.2015, s. 692-9.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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TY - JOUR
T1 - The Copenhagen Standardised MRI protocol to assess the pubic symphysis and adductor regions of athletes
T2 - outline and intratester and intertester reliability
AU - Branci, Sonia
AU - Thorborg, Kristian
AU - Bech, Birthe Højlund
AU - Boesen, Mikael
AU - Magnussen, Erland
AU - Court-Payen, Michel
AU - Nielsen, Michael Bachmann
AU - Hölmich, Per
N1 - Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
PY - 2015/5
Y1 - 2015/5
N2 - BACKGROUND: There is currently no standardised MRI evaluation protocol for athletes who present with symptoms that may relate to the pubic symphysis, the pubic bones, and the adductor muscle insertions. We outline the protocol and reliability data.MATERIAL AND METHODS: Three musculoskeletal radiologists developed an 11-element MRI evaluation protocol defined according to precise criteria and illustrated in a pictorial atlas. Eighty-six male athletes (soccer players and non-soccer players) underwent standardised 3 Tesla MRI of the pelvis. Two external musculoskeletal radiologists were trained to use the protocol and pictorial atlas during two sessions of 2-4 h each. Each radiologist rated all 86 MRI independently. One radiologist evaluated the scans once, the other twice 2 months apart. Cohen κ statistics were used to determine intraobserver and interobserver agreement.RESULTS: The main findings were (1) substantial intraobserver (κ range 0.65-0.67) and moderate interobserver (κ range 0.45-0.52) agreement in rating pubic bone marrow oedema, (2) substantial to moderate intraobserver (κ range 0.49-0.72) and moderate-to-fair interobserver (κ range 0.21-0.52) agreement in rating most other MRI findings, (3) slight intraobserver and interobserver (κ range -0.06-0.05) agreement in rating adductor longus tendinopathy.CONCLUSIONS: The Copenhagen Standardised MRI protocol demonstrated moderate-to-substantial reliability in rating bone marrow oedema, and varied from fair-to-substantial agreement for the majority of MRI features, but showed only slight agreement in rating adductor longus tendinopathy. This rigorous investigation also confirms that while MRI evaluation seems to provide reasonable reliability in rating pubic bone marrow oedema, the evaluation of adductor tendinopathy in a clinical and research setting needs further resolution by continued development and testing of MRI acquisition protocols.
AB - BACKGROUND: There is currently no standardised MRI evaluation protocol for athletes who present with symptoms that may relate to the pubic symphysis, the pubic bones, and the adductor muscle insertions. We outline the protocol and reliability data.MATERIAL AND METHODS: Three musculoskeletal radiologists developed an 11-element MRI evaluation protocol defined according to precise criteria and illustrated in a pictorial atlas. Eighty-six male athletes (soccer players and non-soccer players) underwent standardised 3 Tesla MRI of the pelvis. Two external musculoskeletal radiologists were trained to use the protocol and pictorial atlas during two sessions of 2-4 h each. Each radiologist rated all 86 MRI independently. One radiologist evaluated the scans once, the other twice 2 months apart. Cohen κ statistics were used to determine intraobserver and interobserver agreement.RESULTS: The main findings were (1) substantial intraobserver (κ range 0.65-0.67) and moderate interobserver (κ range 0.45-0.52) agreement in rating pubic bone marrow oedema, (2) substantial to moderate intraobserver (κ range 0.49-0.72) and moderate-to-fair interobserver (κ range 0.21-0.52) agreement in rating most other MRI findings, (3) slight intraobserver and interobserver (κ range -0.06-0.05) agreement in rating adductor longus tendinopathy.CONCLUSIONS: The Copenhagen Standardised MRI protocol demonstrated moderate-to-substantial reliability in rating bone marrow oedema, and varied from fair-to-substantial agreement for the majority of MRI features, but showed only slight agreement in rating adductor longus tendinopathy. This rigorous investigation also confirms that while MRI evaluation seems to provide reasonable reliability in rating pubic bone marrow oedema, the evaluation of adductor tendinopathy in a clinical and research setting needs further resolution by continued development and testing of MRI acquisition protocols.
KW - Adolescent
KW - Adult
KW - Bone Marrow Diseases
KW - Clinical Protocols
KW - Edema
KW - Groin
KW - Hip
KW - Humans
KW - Joint Diseases
KW - Magnetic Resonance Imaging
KW - Male
KW - Musculoskeletal Pain
KW - Observer Variation
KW - Pubic Symphysis
KW - Soccer
KW - Sports Medicine
KW - Tendinopathy
KW - Young Adult
U2 - 10.1136/bjsports-2014-094239
DO - 10.1136/bjsports-2014-094239
M3 - Journal article
C2 - 25488954
VL - 49
SP - 692
EP - 699
JO - British Journal of Sports Medicine
JF - British Journal of Sports Medicine
SN - 0306-3674
IS - 10
ER -
ID: 162446825