Original articleDiagnostic ultrasound in patients with shoulder pain: An inter-examiner agreement and reliability study among Dutch physical therapists
Section snippets
Background
Shoulder pain is the second most reported musculoskeletal symptom (Greving et al., 2012). A common clinical diagnosis for shoulder pain is subacromial pain syndrome (SAPS) (Diercks et al., 2014; Karel et al., 2017). This clinical diagnosis is mainly based on history taking and physical tests (Hegedus et al., 2008; Michener et al., 2009). The term SAPS include pathologies such as: bursitis, tendinosis calcarea, supraspinatus tendinopathy, tear(s) of the rotator cuff, biceps tendinitis and tendon
Study design
A cross-sectional inter-examiner agreement and reliability study. Agreement explores how outcomes of different examiners agree and is expressed in terms of observed agreement and proportion of specific agreement. Specific agreement distinguishes agreement on positive or negative outcomes. Reliability is described as how patients can be distinguished from each other, despite measurement errors (H. C. de Vet et al., 2013). The Medical Ethical Committee of the Erasmus University approved this
Results
We finally included a total of 62 patients, with a mean age of 54.4 years (SD 15.4) of which 36 was female and 26 was male. All patients had unilateral shoulder pain for more than 6 weeks. In 40 of the 62 cases the right shoulder was affected.
Discussion
We found high overall agreement as well as high specific positive agreement for detecting rotator cuff ruptures and other pathology causing SAPS. For both, the overall agreement and the positive agreement was higher than the specific negative agreement. Physical therapists specialized in MSU agree more on the presence of rotator cuff tears and other pathology causing SAPS by using ultrasound than on the absence of pathology.
To the best of our knowledge this is the first inter-examiner agreement
Acknowledgement
This study was funded by SIA-RAAK. The Ministry of Education has made this funding available for the innovation and promotion of research. This study was also partly funded by a program grant of the Dutch Arthritis Foundation.
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