The aim of this study was to evaluate and improve the knowledge and ability of sonographers, who perform shoulder ultrasonography examinations, to detect pathological findings in shoulder x-ray images and furthermore, to examine which pathological findings can be reliably detected by sonographers. The focus of this study was to examine the interpretation process primarily in the evaluation of degenerative changes in patients who are referred to shoulder ultrasonography.

Study material consisted of 50 anonymized shoulder X-ray examinations of patients who had shoulder ultrasonography within two months of the x-ray study. Three sonographers evaluated research material independently, a semi-structured evaluation, of GH-joint, osteophytes, tendon calcification, acromial shape, subacromial space, AC-osteoarthritis and other observations. Musculoskeletal radiologist evaluated images blinded to the interpretation of sonographers. The results were compared between radiologist and sonographers.

!1

PPSHP OYS

SAIRAANHOIDOLLISTEN PALVELUIDEN

DIAGNOSTIIKAN VASTUUALUE

KUVANTAMINENORAL LECTURE AT

ECR 2017

EUROPEAN SOCIETY OF RADIOLOGY PPSHP

Pathological findings in shoulder

x-ray image and ultrasonography

scan

SONOGRAPHER'S ABILITY TO DETECT AND GRADE PATHOLOGICAL FINDINGS

IN SHOULDER RADIOGRAPH

Results Sonographers shoulder x-ray findings accurary compared to radiologist was; GH-joint (intact, luxation, subluxation) 96.7%, GH-joint gap (normal, narrowed, extint) 94%, GH-joint surfaces (normal, sclerosing, deformed) 81.3%, ostheophytes (yes, no, possible) 72,7%, tendon clacific (no, yes measure in mm) 81.4%, acromin shape (type 1, type 2, typ3 or type4) 69,3%, subacromial space (normal, 5-7mm, extint) 93.8%, AC-arthrisis (normal, possible arthrisis, arthrisis, grave arthrisis) 39,4% and other observations 76%.

Conclusion Radiographers’ ability to interpret and report x-rays (1) have been studied widely (2) and good results have been reported in the interpretation of trauma x-ray images (3, 4). In our study, sonographers (Radiographer University of Applied Sciences) performed well in detecting degenerative radiographic findings of shoulder x-ray images. GH-joint, GH-joint space and articular surfaces, tendon calcification and subacromial space were most accurately evaluated when compared to radiologist’s interpretation. The research material will be further utilized in education to improve the sonographers’ skills to evaluate AC-osteoarthritis, acromial shape and osteophytes.

Personal information Mikko Juhani Pakanen, Jouni Haverinen and Minna Heiskanen, Sonographers.

Esa Liukkonen PhD, Research Coordinator.

Jaakko Niinimäki MD, Head Physician.

Department of Radiology, Oulu University Hospital, Oulu, Finland;

References 1. Brealey S, Scally A, Hahn S, Thomas N, Godfrey C, Coomarasamy A. Accuracy of radiographer plain radiograph reporting in clinical practice: a meta-analysis. Clin Radiol. 2005 Feb; 60(2):232-41.

2. Tony N Smith and Marilyn Baird. Radiographers role in radiological reporting: a model to support future demand. The Medical Journal of Australia.2007; 186 (12): 629-631.

3. Johan du Plessis et al. Towards task shifting? A comparison of the accuracy of acute trauma-radiograph reporting by medical officers and senior radiographers in an African hospital. The Pan African Medical Journal. 2015; 21:308.

4. Buskov L, Abild A, Christensen A, Holm O, Hansen C, Christensen H. Radiographers and trainee radiologists reporting accident radiographs: a comparative plain film-reading performance study. Clin Radiol. 2013 Jan;68(1):55-8.

©Mikko Pakanen

!2

In our study, sonographers performed well in

detecting degenerative radiographic findings of shoulder x-ray images.

Three sonographers evaluated research material independently, a semi-structured evaluation, of GH-joint, osteophytes, tendon calcification, acromial shape, subacromial space, AC-osteoarthritis and other observations. Musculoskeletal radiologist evaluated images blinded to the interpretation of sonographers.