Inter- and intra-observer reproducibility of ultrasound analysis of the long head of the biceps - 09/02/20

Doi : 10.1016/j.otsr.2019.11.025

Matthieu Mazaleyrat ^a,^b,⁎ , Raphaël Barthélémy ^c, Loïc Bouilleau ^b,^d, Christophe Charousset ^e, Julien Berhouet ^a,^b
^a Service de Chirurgie Orthopédique et Traumatologique 1&2, CHRU de Tours, Avenue de la République, 37170 Chambray-les-Tours, France
^b Faculté de Médecine, Université de Tours, PRES Centre-Val de Loire Université, Tours, France
^c Service de Radiologie, Clinique d’Imagerie Médicale - Groupe du Mail, 19 Avenue Marie Reynoard, 38100 Grenoble, France
^d Service de Radiologie Adulte, CHRU de Tours, Avenue de la République, 37170 Chambray-les-Tours, France
^e IOAPC Institut Ostéo-Articulaire Paris Courcelles, Paris 8, 60 Rue de Courcelles, 75008 Paris, France

^⁎Corresponding author. Service de Chirurgie Orthopédique et Traumatologique 1&2, CHRU de Tours, Avenue de la République, 37170 Chambray-les-Tours, France.Service de Chirurgie Orthopédique et Traumatologique 1&2, CHRU de ToursAvenue de la RépubliqueChambray-les-Tours37170France

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Abstract

Introduction

Ultrasound assessment of the long head of the biceps (LHB) is difficult. The aim of the present study was to analyze the inter- and intra-observer reproducibility of 2 ultrasound cross-sections not previously assessed: humeral head apex (image 1) and bicipital groove entrance (image 2).

Hypothesis

These ultrasound cross-sectional images allow reliable and reproducible analysis of the intra-articular LHB.

Material and methods

A single-center prospective study was conducted. Inter-observer reproducibility was assessed between 2 radiologists in 20 healthy shoulders (asymptomatic group) and 35 painful shoulders (symptomatic group); intra-observer reproducibility was assessed for 1 observer in 10 healthy shoulders. Quantitative parameters comprised short and long axes and transverse area, and qualitative parameters comprise echogenicity and LHB position.

Results

On images 1 and 2, inter-observer agreement on the 3 quantitative parameters was good to excellent in both subject groups (p<0.05), and more precise and highly reproducible for image 1. Agreement on the 2 qualitative parameters was excellent (p<0.001). Intra-observer reproducibility results were non-significant on all parameters.

Discussion

The 2 intra-articular LHB cross-sections proved reliable and reproducible in painful and in healthy shoulders. A standardized ultrasound protocol could thus enhance the precision of LHB assessment and treatment. The difficulties of LHB measurement, often related to shoulder pathology, may, however, hinder interpretation.