Computed Tomography and Magnetic Resonance Imaging are Similarly Reliable in the Assessment of Glenohumeral Arthritis and Glenoid Version

Document Type : RESEARCH PAPER


1 University of Tennessee-Campbell Clinic Department of Orthopaedic Surgery and Biomedical Engineering, Memphis, Tennessee, USA

2 Duke University Medical School, Department of Orthopaedic Surgery, Durham, North Carolina

3 Memphis Shoulder and Orthopaedic Surgery, Memphis, Tennessee, USA


Background: The purpose of this study was to compare the intra- and inter-observer reliability of CT and T2-weighted
MRI for evaluation of the severity of glenoid wear, glenohumeral subluxation, and glenoid version.
Methods: Sixty-one shoulders with primary osteoarthritis had CT and MRI scans before shoulder arthroplasty. All
slices were blinded and randomized before evaluation. Two fellowship-trained shoulder surgeons and three orthopaedic
surgery trainees reviewed the images to classify glenoid wear (Walch and Mayo classifications) and glenohumeral
subluxation (Mayo classification). Glenoid version was measured using Friedman’s technique. After a minimum twoweek
interval, the process was repeated.
Results: Intraobserver reliability was good for the CT group and fair-to-good for the MRI group for the Walch, Mayo
glenoid, and Mayo subluxation classifications; interobserver reliability was poor for the CT and fair-to-poor for the MRI
group. For the measurement of glenoid version, intraobserver reliability was good the CT and substantial for the MRI
group; interobserver agreement was good for both groups. There were no significant differences in reliability between
staff surgeons and trainees for any of the classifications or measurements.
Conclusion: CT and MRI appear similarly reliable for the classification of glenohumeral wear patterns. For the
measurement of glenoid version, MRI was slightly more reliable than CT within observers. Differences in training
level did not produce substantial differences in agreement, suggesting these systems can be applied by observers of
different experience levels with similar reliability.
Level of evidence: III


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