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Table 2 Assessment of vertical instability

From: The acutely injured acromioclavicular joint – which imaging modalities should be used for accurate diagnosis? A systematic review

Authors

Year of publication

Study design/level of evidence

Number of patients

Classification

Type of imaging

Results (according to classification of Landis/Koch [33])

Kraeutler et al. [34]

2012

Diagnostic study/IV

28

Rockwood

Anteroposterior and axial views: visual classification

Visual (ICC out of 8 investigators):

IeOR = moderate (0.60)

IaOR = good (0.69)

Cho et al. [15]

2014

Diagnostic study/I

28

Rockwood

Bilateral plain anteroposterior and axial views: visual classification.

Bilateral plain anteroposterior and axial views and 3D–CT: visual classification.

Bilateral plain anteroposterior and axial views: visual (ICC out of 10 investigators):

IeOR = slight (0.21)

IaOR = moderate (0.47)

Bilateral plain anteroposterior and axial views and 3D–CT: visual (ICC out of 10 investigators):

IeOR = poor (0.18)

IaOR = moderate (0.57)

Schneider et al. [7]

2014

Retrospective case series/IV

58

Rockwood

Bilateral panoramic stress and axial views: visual and digitally measured (CCI and HD) classification

Visual (range out of 4 investigators):

IeOR = good (0.72–0.74)

IaOR = good to excellent (0.67–0.93)

Digitally measured CCI:

IeOR = excellent (0.85–0.93)

IaOR = excellent (0.90–0.97)

Gastaud et al. [9]

2015

Diagnostic study/I

15

Rockwood

Bilateral comparative anteroposterior views (Zanca-view [4]), axial views and dynamic axial views (Tauber [8]-protocol):

digitally measured (CCI, D/A-ratio, X/Y-ratio, GACA) classification

Digitally measured CCI (range out of 4 investigators):

IeOR = good to excellent (0.69–0.92)

IaOR = good (0.60–0.77)

Digitally measured D/A-ratio:

IeOR = good (0.62–0.67)

IaOR = good to excellent (0.66–0.95)

Schmid and Schmid [23]

1988

Diagnostic study/IV

22

Tossy

Intra-operative findings vs. ultrasound

• Only Tossy III: 100% accordance in classification

Fenkl and Gotzen [20]

1992

Diagnostic study/IV

35

Tossy

Weighted x-ray vs. ultrasound

• 97.2% accordance in classification

• 2.8% underestimation of Tossy grade in ultrasound

Matter et al. [16]

1995

Diagnostic study/IV

20

Tossy

Weighted x-ray vs. ultrasound

• Ultrasound:

Tossy III: 8.8 ± 2.1 mm AC-distance

• Weighted x-ray:

Tossy III: 8.4 ± 3.7 mm AC-distance

Kock et al. [35]

1996

Diagnostic study/IV

29

Tossy

Weighted x-ray vs. ultrasound

• Ultrasound:

Tossy II: 0.48 ± 0.18 AC-Index

Tossy III: 0.20 ± 0.03 AC-Index

• Weighted x-ray:

Tossy II: 0.50 ± 0.19 AC-Index

Tossy III: 0.20 ± 0.03 AC-Index

Iovane et al. [22]

2004

Diagnostic study/IV

18

Rockwood

Weighted x-ray vs. ultrasound

• 100% accordance in classification (only Rockwood I – III)

Schaefer et al. [3]

2006

Diagnostic study/IV

13

Rockwood

Non-weighted x-ray vs. mri

• 84.6% accordance in classification

• 15.4% underestimation of Rockwood grade in x-ray

Takase [18]

2011

Diagnostic study/IV

25

Rockwood

Non-weighted x-ray vs. mri

• 92% accordance in classification

• 8% overestimation of Rockwood grade in x-ray

Nemec et al. [19]

2011

Diagnostic study/IV

44

Rockwood

Non-weighted x-ray vs. mri

• 52.2% accordance in classification

• 36.4% overestimation of Rockwood grade in x-ray

• 11.4% underestimation of Rockwood grade in x-ray

  1. ICC = intraclass correlation coefficient, IeOR = inter-observer reliability, IaOR = intraobserver Reliability, CCI = coracoclavicular index, AC-width index = acromioclavicular-width index [10], D/A-ratio = vertical displacement of the clavicle9