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14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT)

17.06. - 21.06.2019, Berlin

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The reliability of tomosynthesis for Heberden’s node

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  • presenting/speaker Masashi Matsuta - Department of Orthopaedic Surgery, Kanazawa University, Ishikawa Kanazazwa Takaramachi, Japan
  • Kaoru Tada - Department of Orthopaedic Surgery, Kanazawa University, Ishikawa Kanazazwa Takaramachi, Japan
  • Tadahiro Nakajima - Department of Orthopaedic Surgery, Kanazawa University, Ishikawa Kanazazwa Takaramachi, Japan
  • Mika Nakada - Department of Orthopaedic Surgery, Kanazawa University, Ishikawa Kanazazwa Takaramachi, Japan
  • Hiroyuki Tsuchiya - Department of Orthopaedic Surgery, Kanazawa University, Ishikawa Kanazazwa Takaramachi, Japan

International Federation of Societies for Surgery of the Hand. International Federation of Societies for Hand Therapy. 14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT). Berlin, 17.-21.06.2019. Düsseldorf: German Medical Science GMS Publishing House; 2020. DocIFSSH19-1207

doi: 10.3205/19ifssh0542, urn:nbn:de:0183-19ifssh05421

Published: February 6, 2020

© 2020 Matsuta et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

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Objectives/Interrogation: Radiography is widely used for the diagnosis of Heberden's node, however, few studies have reported the accuracy of this technique. The purpose of this study was to report the intra- and inter-examiner errors in the diagnosis of Heberden's nodes using radiography and tomosynthesis.

Methods: Our study included 136 fingers (17 persons; 6 men and 11 women; average age, 56.7 years) from individuals who underwent radiography and tomography at our hospital. Three examiners evaluated osteoarthritis using the Kellgren/Lawrence classification, from index to little fingers, of each DIP joint. The inter-examiner error was calculated from the data, which were collected twice in total, by the same orthopedic non-specialist at a one-week interval. Intra-examiner error was calculated from the data of three individuals, of whom two were orthopedic non-specialists (examiners 1 and 2) and one was an orthopedic specialist (examiner 3). For the statistical method, we used Cohen's kappa and Pearson's (r) correlation coefficients.

Results and Conclusions: The kappa coefficient for inter-examiner error related to radiographic examination showed a moderate match (examiner 1: kappa= 0.497), and the kappa coefficient for intra-examiner error related to radiographic examination showed a mild-to-moderate match (kappa 12 = 0.571, kappa 13 = 0.404, kappa 23 = 0.343). The kappa coefficient for intra-examiner error related to tomographic examination also showed a moderate match (examiner 1: kappa = 0.571), but the kappa coefficient for the inter-examiner measurement error showed very slight-to-moderate agreement (kappa12 = 0.522, kappa 13 = 0.201, kappa 23 = 0.189). The simple radiography and tomography examination methods showed a very strong correlation, with r = 0.683.

For determining the Heberden's node grade, the Kellgren/Lawrence classification based on radiographic examination is commonly used.The inter-examiner errors were moderate in radiography and tomography for Heberden's node diagnoses, but the measurement accuracy of tomography was lower than that of radiography. The correlation between radiography and tomography was considerably strong; therefore, it is unnecessary to perform tomography when diagnosing Heberden's nodes.