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Updated: Aug 24, 2026

Software-Assisted Quantitative Measurement of Osteoarthritic Subchondral Bone Thickness
Published on: March 18, 2022
Intraobserver and interobserver reliability of Catterall, Herring, Salter-Thompson and Stulberg classification
Haluk Agus1, Onder Kalenderer, Gürkan Eryanlmaz
1Orthopaedics and Traumatology, S.S.K. Tepecik Educational Hospital, Karşiyaka, Izmir, Turkey.
Objective:
To assess the percentage agreement and intraobserver and interobserver reliability among Catterall, Salter-Thompson, Herring and Stulberg classification systems with special reference to the stage of treatment.
Methods:
Anteroposterior and frog-leg radiographs of 10 patients were evaluated by 18 reviewers on two occasions. Each patient had three sets of radiographs of different stages of disease: before treatment, 6-12 months after the initiation of treatment and at least 5 years after the treatment.
Results:
Interobserver-intraobserver agreement rates for Catterall (set 1), Salter-Thompson (set 1), Herring (set 1), Catterall (set 2), Herring (set 2) and Stulberg (set 3) were 0.6203-0.6862, 0.6037-0.5758, 0.5955-0.4946, 0.5782-0.3864, 0.3878-0.1133 and 0.7912-0.7733, respectively.
Conclusions:
The results of our study suggest the use of Catterall and Salter-Thompson systems prior to treatment and the Stulberg system at the end of the treatment at skeletal maturity. However, evaluation of the patients during the treatment period is still a dilemma and necessitates a new more reliable classification system.
