Well-founded practice or personal preference: a comparison of established techniques for measuring ulnar variance in healthy children and adolescents.

European Radiology
Laura S KoxM Maas

Abstract

Ulnar variance is a clinical measure used to determine the relative difference in length between the radius and ulna. We aimed to examine consistency in ulnar variance measurements and normative data in children and adolescents using the perpendicular and the Hafner methods. Two raters measured ulnar variance on hand radiographs of 350 healthy children. Participants' mean calendar and skeletal ages were 12.3 ± 3.6 and 12.0 ± 3.7 years, 52% were female. Raters used the perpendicular method, an adapted version of the perpendicular method (in which the distal radial articular surface is defined as a sclerotic rim) and the Hafner method, being the distance between the most proximal points of the ulnar and radial metaphyses (PRPR) and the distance between the most distal points of both (DIDI). Intraclass correlation coefficients (ICCs) for intermethod consistency and inter- and intrarater agreement were calculated using a two-way ANOVA model. Variability and limits of agreement were determined using the Bland-Altman method. The interrater ICC was 0.75 (95% CI, 0.61-0.84) for the adapted perpendicular method, 0.88 (95% CI, 0.80-0.93) for PRPR, and 0.94 (95% CI, 0.90-0.97) for DIDI. The intermethod consistency ICC was 0.60 (95% CI, 0....Continue Reading

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