Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2015 Oct;24(10):1613-8.
doi: 10.1016/j.jse.2015.03.029. Epub 2015 May 5.

Osteochondritis dissecans of the humeral capitellum: reliability of four classification systems using radiographs and computed tomography

Femke M A P Claessen  1 , Kimberly I M van den Ende  2 , Job N Doornberg  3 , Thierry G Guitton  3 , Denise Eygendaal  4 , Michel P J van den Bekerom  5 ; Shoulder and Elbow Platform & Science of Variation Group
Collaborators, Affiliations

Osteochondritis dissecans of the humeral capitellum: reliability of four classification systems using radiographs and computed tomography

Femke M A P Claessen et al. J Shoulder Elbow Surg. 2015 Oct.

Abstract

Background: The radiographic appearance of osteochondritis dissecans (OCD) of the humeral capitellum varies according to the stage of the lesion. It is important to evaluate the stage of OCD lesion carefully to guide treatment. We compared the interobserver reliability of currently used classification systems for OCD of the humeral capitellum to identify the most reliable classification system.

Methods: Thirty-two musculoskeletal radiologists and orthopaedic surgeons specialized in elbow surgery from several countries evaluated anteroposterior and lateral radiographs and corresponding computed tomography (CT) scans of 22 patients to classify the stage of OCD of the humeral capitellum according to the classification systems developed by (1) Minami, (2) Berndt and Harty, (3) Ferkel and Sgaglione, and (4) Anderson on a Web-based study platform including a Digital Imaging and Communications in Medicine viewer. Magnetic resonance imaging was not evaluated as part of this study. We measured agreement among observers using the Siegel and Castellan multirater κ.

Results: All OCD classification systems, except for Berndt and Harty, which had poor agreement among observers (κ = 0.20), had fair interobserver agreement: κ was 0.27 for the Minami, 0.23 for Anderson, and 0.22 for Ferkel and Sgaglione classifications. The Minami Classification was significantly more reliable than the other classifications (P < .001).

Conclusions: The Minami Classification was the most reliable for classifying different stages of OCD of the humeral capitellum. However, it is unclear whether radiographic evidence of OCD of the humeral capitellum, as categorized by the Minami Classification, guides treatment in clinical practice as a result of this fair agreement.

Keywords: Osteochondritis dissecans; arthroscopy; classification; humeral capitellum; interobserver study; sport traumatology.

PubMed Disclaimer