Interobserver and intraobserver agreement in radiographic diagnosis of osteoporosis
Background: Osteoporosis is a common bone disorder which means paucity of bone particularly of trabecular bone. This leads to increased tendency to fractures and bone pains. The radiological diagnostic workup usually starts from plain x-rays followed by bone mass measurement techniques. Aims: To determine the inter-and intra-observer agreement in plain x-ray diagnosis of osteoporosis using a standardized grading system.
Setting: It was a cross-sectional analytical study conducted from May 2004 to June 2005 at Radiology department Dow University of Health Sciences and Civil Hospital, Karachi and Osteoporosis Diagnostic Clinic Karachi.
Patients and Methods: Plain non digital x-rays of femur of post menopausal females (a group known to be at risk of and clinically suspected with osteoporosis) were independently read by three qualified professionals-two radiologists and a nuclear physician specialized in osteoporosis diagnosis. Standardized radiological grades of osteoporosis (Singh Index) were assigned to plain x-rays of pelvis and femur. Kappa statistics were used to determine inter- and intra-observer agreement by computing k-value.
Results: A total of 98 patients were included in the study. All were post menopausal females with age of 59+/-6.5 years. Kappa (k-) value for inter-observer agreement ranged from 0.21 to 0.44. For intra-observer agreement, it was 0.69 to 0.78.
Conclusion: The inter- and intra-observer agreement for diagnosis of osteoporosis on plain x-rays alone is markedly low,necessitating the use of multiple and sensitive techniques rather than plain x-rays alone.
Publication (Name of Journal)
Pakistan Journal of Medical Research
Memon, M. A.,
Memon, A. A.
(2007). Interobserver and intraobserver agreement in radiographic diagnosis of osteoporosis. Pakistan Journal of Medical Research, 46(4), 103-106.
Available at: https://ecommons.aku.edu/pakistan_fhs_mc_radiol/397