Elbow stiffness: effectiveness of conventional radiography and CT to explain osseous causes
Veronika Zubler, Nadja Saupe, Bernhard Jost, Christian W A Pfirrmann, Juerg Hodler & Marco Zanetti
abstract
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OBJECTIVE
The purpose of our study was to evaluate the effectiveness of
conventional radiography and CT for explaining the osseous causes of
elbow stiffness.
MATERIALS AND METHODS
Two independent readers analyzed loose bodies and osteophytes on
conventional radiography and CT (or CT arthrography) of the elbow in
94 consecutive patients (71 men, 23 women; mean age, 41 years;
range, 18-68 years). Arthroscopic or surgical correlation was
available in 58 (62%) patients. In all 94 patients, the expected
restriction of motion was measured on images and correlated
(Pearson's correlation) with the clinical restriction of motion.
Kappa statistics were performed for interobserver agreement.
RESULTS
Accuracy for detecting loose bodies was 67% with conventional
radiography and 79% with CT. Differences in accuracy were most
pronounced for detecting loose bodies in the posterior joint space
(64% for conventional radiography vs 79% for CT). Accuracy for
detecting osteophytes was 69% with conventional radiography and 76%
with CT. Expected restriction of motion on conventional radiography
correlated significantly with clinical restriction for only one
reader for flexion (R = 0.21, p = 0.04). Expected restriction of
extension on CT correlated significantly with clinical restriction
of motion by both readers (R = 0.34 and 0.33, p = 0.001 and 0.001,
respectively). Expected restriction of flexion on CT correlated
significantly by one reader (R = 0.24, p = 0.02). Interobserver
agreement with regard to detection of both loose bodies and
osteophytes was higher for CT (kappa = 0.83 and 0.76) than for
conventional radiography (0.64 and 0.60).
CONCLUSION
CT is more effective than conventional radiography in explaining the
osseous causes of elbow stiffness.
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citation
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Zubler V, Saupe N, Jost B, Pfirrmann C W A, Hodler J, Zanetti M.
Elbow stiffness: effectiveness of conventional radiography and CT to
explain osseous causes. AJR Am J Roentgenol 2010; 194:W515-20.
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type
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journal paper/review (English)
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date of publishing
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28-6-2010
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journal title
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AJR Am J Roentgenol (194/6)
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ISSN electronic
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1546-3141
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pages
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W515-20
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PubMed
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20489071
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DOI
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10.2214/AJR.09.3741
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contact
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Bernhard Jost
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additional links & downloads