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Updated: Jul 31, 2026
10:07
Measurement of Dynamic Scapular Kinematics Using an Acromion Marker Cluster to Minimize Skin Movement Artifact
Published on: February 10, 2015
Reliability of radiographic evaluation for acromial morphology
A S Bright1, B Torpey, D Magid
1Department of Orthopaedics, Johns Hopkins University, Baltimore, Maryland, USA.
Skeletal Radiology
|February 7, 1998
Summary
The Bigliani classification system for acromial morphology shows poor interobserver reliability among shoulder specialists. More precise criteria are needed for accurate rotator cuff disease evaluation.
Area of Science:
- Orthopedics
- Radiology
- Shoulder Surgery
Background:
- Bigliani's classification system is a standard method for assessing acromial morphology in rotator cuff disease.
- Reliability of this classification is crucial for accurate diagnosis and treatment planning.
Purpose of the Study:
- To evaluate the interobserver and intraobserver reliability of Bigliani's acromial morphology classification.
- To assess the impact of observer experience on classification accuracy.
Main Methods:
- Retrospective review of 40 shoulder radiographs by six observers with varying experience levels.
- Observers classified acromial morphology (Type I, II, III) twice over four months.
- Interobserver and intraobserver reliability calculated using kappa statistics.
Main Results:
- Overall agreement among observers was low (18%).
- Mean interobserver reliability (kappa=0.35) indicated fair agreement.
- Mean intraobserver repeatability (kappa=0.55) indicated moderate agreement, with no significant difference based on experience level.
Conclusions:
- Bigliani's classification system demonstrates suboptimal reliability for acromial morphology.
- Current criteria are insufficient for consistent classification, necessitating refinement for clinical application.
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