Related Experiment Video
Updated: Apr 6, 2026
Reverse Total Shoulder Arthroplasty
Published on: July 5, 2011
A feedback protocol improves the diagnostic performance of MR arthrography by experienced musculoskeletal
Susan van Grinsven1, Corné van Loon1, Maarten van Gorp2
1Department of Orthopaedics, Rijnstate Hospital, PO Box 9555, 6800 TA Arnhem, The Netherlands.
Purpose:
To prospectively evaluate the diagnostic performance of magnetic-resonance-arthrography (MRA) by experienced musculoskeletal radiologists in patients with traumatic-anterior-shoulder-instability (TASI), after feedback protocol execution.
Materials And Methods:
Forty-five surgically confirmed MRA's were used to enhance personal feedback, to discuss differences in outcome between MRA assessment and surgical findings and to fine-tune definition interpretation agreement of 7 different TASI-related lesions, between experienced musculoskeletal radiologists and experienced orthopaedic shoulder surgeons. After execution of the feedback protocol 20 new, surgically confirmed, MRA's were assessed by 2 experienced musculoskeletal radiologists using a seven-lesion standardized scoring form. Kappa coefficients, sensitivity, specificity, and differences in percentage agreement or correct diagnosis (p-value, McNemar's test) were calculated per lesion and overall per 7 lesion types to assess whether diagnostic reproducibility and accuracy was improved.
Results:
Per 7 lesion types, the overall kappa and percentage of agreement, between the 2 radiologists, were dramatically increased in comparison with our former study (k=0.81 versus k=0.48 and 90.7% versus 78.2%, respectively). The overall sensitivity of radiologist 1 increased from 45.9% to 87.8%, the overall sensitivity of radiologist 2 increased from 63.5% to 79.6% and the overall specificity of radiologist 2 increased from 80.1% to 85.7%. Furthermore, the overall percentage of correct diagnosis of both radiologist was also exceedingly higher (85.7% and 83.6%) compared to our former study (74.4% and 74.8%).
Conclusion:
The implementation of our feedback protocol dramatically improved the reproducibility and accuracy of high field MRA by experienced musculoskeletal radiologist in patients with traumatic anterior shoulder instability.
