Radiological assessment of medial coronoid disease in the dog - an interobserver study

Radiological assessment of medial coronoid disease in the dog - an interobserver study This study compares the interpretation of elbow x-rays for medial coronoid disease in dogs between two radiologists. One of them is an experienced board-certified radiologist; the other one is a second-year resident of the European College of Veterinary Diagnostic Imaging. They had to assess the osteophytic formations, other secondary changes caused by coronoid disease, and the elbow dysplasia (ED) score according to Lang. The interobserver consensus was calculated using the Kappa coefficient and Spearman's rank correlation. The Kappa coefficient showed a weak to moderate level of agreement. The rating of a defined osteophyte score was -0.036, increased sclerosis caudal to the coronoid process was -0.056, decreased outline of the coronoid process was 0.24, decreased density of the coronoid process was 0.23 and the existence of superficial erosive (kissing) lesions at the humeral trochlea was also 0.23. The calculation of Spearman's rank correlation for the existence of a short radius was 0.24. The ED score according to Lang showed the highest level of agreement (0.58). Although it could not be proven due to the study's design, incorrect interpretations by the inexperienced radiologist seem to be likely. For example, fragments that were identified on the x-rays by the inexperienced radiologist but not by the board-certified radiologist could not be found in a subsequent arthroscopy. Further studies should evaluate the influence of the examiner's experience and the value of x-rays for the diagnosis of medial coronoid disease in dogs.