Journal article
Anatomy-based MRI assessment of the iliopsoas muscle complex after pertrochanteric femoral fracture.
- Kaniewska M Institute of Radiology, Kantonsspital Baden, Baden, Switzerland. malw.kaniewska@gmail.com.
- Schenkel M Centre for Orthopaedic Surgery, Kantonsspital Aarau und Baden, Baden, Switzerland.
- Eid K Centre for Orthopaedic Surgery, Kantonsspital Aarau und Baden, Baden, Switzerland.
- Bühler T Centre for Orthopaedic Surgery, Kantonsspital Aarau und Baden, Baden, Switzerland.
- Kubik-Huch RA Institute of Radiology, Kantonsspital Baden, Baden, Switzerland.
- Anderson SE Institute of Radiology, Kantonsspital Baden, Baden, Switzerland.
- 2018-09-05
Published in:
- Skeletal radiology. - 2019
Femoral fractures
Hip
Hip joint
Magnetic resonance imaging
Muscle strength
Psoas muscle
Reproducibility
Skeletal muscle
Adult
Aged
Aged, 80 and over
Anatomic Landmarks
Female
Femoral Fractures
Humans
Magnetic Resonance Imaging
Male
Middle Aged
Muscle Strength
Psoas Muscles
Reproducibility of Results
English
OBJECTIVE
To evaluate the quality of the iliopsoas muscle complex after pertrochanteric femoral fracture, using MRI; to propose an anatomy-based evaluation of the iliopsoas muscle complex; and to determine the inter-reader reliability of two classifications of fatty muscle degeneration.
MATERIALS AND METHODS
We included adult patients with a displaced lesser trochanter following pertrochanteric femoral fracture. Muscle quality was evaluated using the Goutallier and Slabaugh classifications at three levels (L4/L5, L5/S1, and the anterior inferior iliac spine). Two radiologists independently reviewed the MRIs, and force measurement was performed on both hips. Linear mixed-effects models were used to determine the effect of fracture on muscle quality and strength, and Cohen's kappa statistic was used to assess inter-reader agreement.
RESULTS
In the 18 patients included, the iliopsoas muscle complex showed higher grades of fatty muscle degeneration on the fractured side than on the non-fractured side. The mean difference between muscle strength on the fractured vs the non-fractured side was -12 N (p > 0.05). Inter-reader agreement for the Goutallier and Slabaugh classifications was good and very good respectively (weighted K = 0.78 and 0.85 respectively).
CONCLUSION
Fatty muscle degeneration of the iliopsoas muscle complex after pertrochanteric femoral fracture was evident using both classification systems; however, fatty muscle degeneration resulted in only a minimal reduction of muscle strength. To provide a thorough assessment of iliopsoas muscle complex quality, we suggest evaluating it at different anatomical levels. Regarding inter-reader agreement, the Slabaugh classification was superior to the Goutallier classification.
To evaluate the quality of the iliopsoas muscle complex after pertrochanteric femoral fracture, using MRI; to propose an anatomy-based evaluation of the iliopsoas muscle complex; and to determine the inter-reader reliability of two classifications of fatty muscle degeneration.
MATERIALS AND METHODS
We included adult patients with a displaced lesser trochanter following pertrochanteric femoral fracture. Muscle quality was evaluated using the Goutallier and Slabaugh classifications at three levels (L4/L5, L5/S1, and the anterior inferior iliac spine). Two radiologists independently reviewed the MRIs, and force measurement was performed on both hips. Linear mixed-effects models were used to determine the effect of fracture on muscle quality and strength, and Cohen's kappa statistic was used to assess inter-reader agreement.
RESULTS
In the 18 patients included, the iliopsoas muscle complex showed higher grades of fatty muscle degeneration on the fractured side than on the non-fractured side. The mean difference between muscle strength on the fractured vs the non-fractured side was -12 N (p > 0.05). Inter-reader agreement for the Goutallier and Slabaugh classifications was good and very good respectively (weighted K = 0.78 and 0.85 respectively).
CONCLUSION
Fatty muscle degeneration of the iliopsoas muscle complex after pertrochanteric femoral fracture was evident using both classification systems; however, fatty muscle degeneration resulted in only a minimal reduction of muscle strength. To provide a thorough assessment of iliopsoas muscle complex quality, we suggest evaluating it at different anatomical levels. Regarding inter-reader agreement, the Slabaugh classification was superior to the Goutallier classification.
- Language
-
- English
- Open access status
- closed
- Identifiers
-
- DOI 10.1007/s00256-018-3048-8
- PMID 30178103
- Persistent URL
- https://sonar.ch/global/documents/126499
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