Reliability of digital radiographs for pediatric lower extremity alignment.

Background: Digital radiography is the standard method for sharing and storing radiographs. The purpose of this study was to evaluate the interobserver and intraobserver reliability of computer-based and manual measurement methods in determining lower extremity alignment on digital images of pediatr...

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Published in:Journal of Pediatric Orthopaedics Vol. 32; no. 6; pp. 631 - 636
Main Authors: Nowicki PD, Vanderhave KL, Farley FA, Kuhns LR, Dahl W, Caird MS, Nowicki, Philip D, Vanderhave, Kelly L, Farley, Frances A, Kuhns, Lawrence R, Dahl, William, Caird, Michelle S
Format: research Journal Article
Published: Lippincott Williams & Wilkins 2012 Sep
Online Access:View this record in EBSCOhost
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      dt: 2012 Sep
      vid: 32
      iid: 6
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      pub: Lippincott Williams & Wilkins
      place: Baltimore, Maryland
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        10.1097/BPO.0b013e3182694e07
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        atl: Reliability of digital radiographs for pediatric lower extremity alignment.
      aug:
        au:
          Nowicki PD
          Vanderhave KL
          Farley FA
          Kuhns LR
          Dahl W
          Caird MS
          Nowicki, Philip D
          Vanderhave, Kelly L
          Farley, Frances A
          Kuhns, Lawrence R
          Dahl, William
          Caird, Michelle S
        affil: Department of Orthopaedic Surgery, Kalamazoo Center for Medical Studies, Michigan State University, Kalamazoo, MI, USA
      sug:
        subj:
          Femur Radiography
          Leg Radiography
          Radiographic Image Enhancement Methods
          Tibia Radiography
          Adolescence
          Child
          Female
          Femur Abnormalities
          Human
          Image Interpretation, Computer Assisted Methods
          Leg Abnormalities
          Male
          Observer Bias
          Reproducibility of Results
          Tibia Pathology
          Adolescent: 13-18 years
          Child: 6-12 years
          Female
          Male
      ab: Background: Digital radiography is the standard method for sharing and storing radiographs. The purpose of this study was to evaluate the interobserver and intraobserver reliability of computer-based and manual measurement methods in determining lower extremity alignment on digital images of pediatric patients. Methods: Thirty-two digital standing long leg radiographs of pediatric patients were evaluated with 9 varus, 11 valgus, and 12 neutral alignment films. Six evaluators measured the digital images with a standard computer-based measurement method twice and a manual paper print out method twice. Measurements included the lateral distal femoral angle (LDFA), the medial proximal tibia angle (MPTA), the joint line congruency angle, and the mechanical axis deviation (MAD). Interobserver and intraobserver reliability for computer-based and manual methods were calculated using intraclass correlation coefficients. Results: The interobserver reliability for all angular measurements was found to be fair to good for both measurement methods. The MAD had excellent intraobserver and interobserver reliability. LDFA and MPTA interobserver reliabilities were better by the manual method than the computer-based method. Intraobserver reliability was higher in the computer-based LDFA than manual methods, whereas the MPTA measurements were more reliable by manual methods. Conclusions: Computer-based and manual methods for determining lower extremity alignment from digital radiographs are not dissimilar and both provide fair to good reliability. The MAD was a highly reliable measurement. Overall, measurement of the digital images was not as reliable by either method as measurement of traditional full-length teloroentgenograms. The observer should be familiar with the measurement program to minimize errors. Digital images can be measured reliably and then used for treatment decisions, however, time and care should be taken with measurements. Level Of Evidence: Diagnostic level II.
      pubtype: Academic Journal
      doctype:
        research
        Journal Article
      ougenre: Article
    language: English
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