Intraobserver Reliability on Classifying Bursitis on Shoulder Ultrasound

Area of Science:

• Musculoskeletal Radiology
• Diagnostic Imaging
• Orthopedic Surgery

Background:

• Shoulder pain is frequently caused by bursitis, a condition requiring accurate diagnosis and grading for effective management.
• Ultrasonography is a key imaging modality for evaluating shoulder bursitis, but inter-reader reliability in grading can vary.
• Standardized grading of bursitis is essential for guiding appropriate treatment strategies and improving patient outcomes.

Purpose of the Study:

• To evaluate the inter-reader reliability of fellowship-trained musculoskeletal radiologists in grading shoulder bursitis on ultrasonography.
• To assess the correlation between radiologists' years of experience and their reliability in grading bursitis.
• To determine if consistent grading of shoulder bursitis can be achieved among experienced musculoskeletal radiologists.

Main Methods:

• Retrospective analysis of 70 ultrasonography cases diagnosed with shoulder bursitis.
• Single-image review of the subacromial-subdeltoid bursa by 10 fellowship-trained musculoskeletal radiologists.
• Assessment of intra-observer variability using Cohen's kappa coefficient and correlation with experience via linear regression.

Main Results:

• Inter-reader reliability (Kappa values) ranged from 0.53 to 0.91, indicating moderate to almost perfect agreement.
• A moderate positive correlation (r = 0.69) was observed between increased years of experience and improved grading variability.
• Fellowship-trained musculoskeletal radiologists showed substantial consistency in grading shoulder bursitis severity.

Conclusions:

• Fellowship-trained musculoskeletal radiologists exhibit moderate to almost perfect reliability in grading shoulder bursitis via ultrasonography.
• Increasing experience among these radiologists is associated with enhanced grading consistency.
• Reliable grading of shoulder bursitis can support clinicians in making more confident treatment decisions for patients experiencing shoulder pain.