Detection of femoroplasty on pre- and post-arthroscopic comparison radiographs following treatment of femoroacetabular impingement syndrome: multi-reader accuracy and agreement study.
Steffen J Haider, Alan H Siegel, Kevin F Spratt, James B Ames, J Allen Graham, Yvonne Y Cheung
Author Information
Steffen J Haider: Department of Radiology, Columbia University Medical Center, New York, NY, USA.
Alan H Siegel: Department of Radiology, Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA.
Kevin F Spratt: Statistician & Methodologist Innovation Labs, Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA.
James B Ames: Department of Orthopedic Surgery, Dartmouth Hitchcock Medical Center, Lebanon, NH, USA.
J Allen Graham: Department of Radiology, Veteran Administration Hospital, White River Junction, VT, USA.
Yvonne Y Cheung: Department of Radiology, Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA. Yvonne.cheung@hitchcock.org. ORCID
OBJECTIVE: To assess diagnostic accuracy and agreement among radiologists in detecting femoroplasty on pre- and post-arthroscopic comparison frog lateral and anteroposterior (AP) pelvic radiographs after treatment of femoroacetabular impingement (FAI) syndrome. MATERIALS AND METHODS: In this retrospective, cross-sectional study, 86 patients underwent hip arthroscopy (52 with and 34 without femoroplasty) for treatment of FAI syndrome. Three radiologists blinded to clinical data and chronological order of the pre- and post-arthroscopic comparison radiographs independently examined AP pelvis and frog lateral radiographs to detect femoroplasty changes. Statistical analysis outputs included diagnostic accuracy parameters and inter- and intra-observer agreement. RESULTS: Identification of femoroplasty in the frog lateral projection has mean sensitivity 70%, specificity 82%, inter-observer agreement κ 0.74-0.76 and intra-observer agreement κ 0.72-0.85. Using the AP pelvis projection to detect femoroplasty has mean sensitivity 32%, specificity 71%, inter-observer agreement κ 0.47-0.65, and intra-observer agreement κ, 0.56-0.84. CONCLUSIONS: Radiologists are only moderately sensitive, though more specific, in femoroplasty detection in the frog lateral projection. The AP pelvis projection yields lower sensitivity and specificity. Both projections have moderate inter- and intra-observer agreement.
