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Validity of Cobb angle measurements using digitally photographed radiographs
Pedro A Ricart1, Tate M Andres, Alexios Apazidis
1Department of Orthopaedic Surgery, NYU Hospital for Joint Diseases, 301 East 17th St, New York, NY 10003, USA.
Background Context:
Advances in technology are influencing the way that medical information is archived and shared. Considering that an estimated two-thirds of the world has little or no orthopedic care, high demand exists for adequate consultation regarding diagnostic images in orthopedic specialties.
Purpose:
To validate the use of photographed scoliosis films for the accurate interpretation of Cobb angles.
Study Design:
Retrospective review.
Patient Sample:
Thirty scoliosis radiographs.
Outcome Measure:
Cobb angle.
Methods:
Thirty scoliosis radiographs were photographed using a digital camera from a straight and a 45° angle position. Cobb angles were then measured on the digital images using standard measurement software. Comparison was made between two types of curves: convex and concave, relative to the left side (side for the angled position).
Results:
There was excellent reproducibility between the measurements of the conventional radiographs and the photographs taken from a straight on position, p value of .97 for convex curves and p value of .98 for concave curves. Photographs taken from a 45° angle significantly increased the magnitude of the curve convex to the angle (p=.001).
Conclusion:
Sharing photographs of scoliosis radiographs can be done with reliability if the image is taken directly in front of the viewbox rather than at an oblique angle; pictures taken at oblique angles are prone to misinterpretation of curve magnitude.
