Reliability of point-of-care shoulder ultrasound measurements for subacromial impingement in asymptomatic participants.
Xiaoning Yuan, Ryan Lowder, Kathelynn Aviles-Wetherell and 3 others
PMID 36189022WHAT IT FOUND
When one therapist scans and measures a shoulder, results are consistent.
When a second therapist scans, results vary widely. If two people measure the same saved images, they agree. The variability comes from how the probe is placed, not how the image is read.
Key findings
01Reliability was high when the same clinician scanned and measured, but dropped to moderate or poor when a different clinician scanned the same person.
02Two different clinicians measuring the exact same saved ultrasound images showed excellent agreement, indicating the variability stems from probe positioning rather than image interpretation.
03The acromion-greater tuberosity distance showed the largest minimal detectable difference and was deemed too unreliable for use as an outcome measure.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The study included only 17 asymptomatic participants, so the reliability findings may not apply to patients with shoulder pain or structural abnormalities. All scans were performed on the same day, so the study did not assess test-retest reliability over time. The participants were young and healthy, limiting generalizability to older or more complex patient populations. The sonographers had specific fellowship training, which may not reflect the experience level of all clinicians using point-of-care ultrasound.
Declared interests
The paper does not report any conflicts of interest or funding sources.
The easy way to misread this
Do not assume that two therapists scanning the same shoulder will get comparable numbers. The study shows that variability is driven by probe placement, not image reading. Only the same clinician scanning and measuring, or two clinicians measuring the same saved image, produced reliable agreement.