{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T19:04:35Z","timestamp":1777662275961,"version":"3.51.4"},"reference-count":26,"publisher":"SAGE Publications","issue":"6","license":[{"start":{"date-parts":[[2016,11,30]],"date-time":"2016-11-30T00:00:00Z","timestamp":1480464000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Hand (New York, N,Y.)"],"published-print":{"date-parts":[[2017,11]]},"abstract":"<jats:p>Background: The appearance of early Kienb\u00f6ck disease on radiographs and magnetic resonance imaging (MRI) may be difficult to distinguish from other conditions that affect the lunate. We aimed to assess the interobserver agreement in the diagnosis of early Kienb\u00f6ck disease when evaluated on different imaging modalities. Methods: Forty-three hand surgeon members of the Science of Variation Group were randomized to evaluate radiographs and 35 hand surgeons to evaluate radiographs and MRI scans of 26 patients for the presence of Kienb\u00f6ck disease, the lunate type, and the ulnar variance. We used Fleiss\u2019 kappa analysis to assess the interobserver agreement for categorical variables and compared the \u03ba values between the 2 groups. Results: We found that agreement on the diagnosis of early Kienb\u00f6ck disease was fair (\u03ba, 0.36) among observers who evaluated radiographs alone and moderate (\u03ba, 0.58) among observers who evaluated MRI scans in addition to radiographs, and that the difference in \u03ba values was not statistically significant ( P = .057). Agreement did not differ between observers based on imaging modality with regard to the assessment of the lunate type ( P = .75) and ulnar variance ( P = .15). Conclusions: We found, with the numbers evaluated, a notable but nonsignificant difference in agreement in favor of observers who evaluated MRI scans in addition to radiographs compared with radiographs alone. Surgeons should be aware that the diagnosis of Kienb\u00f6ck disease in the precollapse stages is not well defined, as evidenced by the substantial interobserver variability.<\/jats:p>","DOI":"10.1177\/1558944716677538","type":"journal-article","created":{"date-parts":[[2016,11,7]],"date-time":"2016-11-07T23:08:31Z","timestamp":1478560111000},"page":"573-578","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":3,"title":["Interobserver Agreement in Diagnosing Early-Stage Kienb\u00f6ck Disease on Radiographs and Magnetic Resonance Imaging"],"prefix":"10.1177","volume":"12","author":[{"given":"Wouter F.","family":"van Leeuwen","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stein J.","family":"Janssen","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thierry G.","family":"Guitton","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery, University Medical Center Groningen, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Neal","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Ring","sequence":"additional","affiliation":[{"name":"Department of Surgery and Perioperative Care, Dell Medical School, The University of Texas at Austin, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2016,11,30]]},"reference":[{"key":"bibr1-1558944716677538","doi-asserted-by":"publisher","DOI":"10.5435\/00124635-200103000-00006"},{"key":"bibr2-1558944716677538","doi-asserted-by":"publisher","DOI":"10.2214\/AJR.12.10029"},{"key":"bibr3-1558944716677538","doi-asserted-by":"publisher","DOI":"10.2214\/AJR.13.11606"},{"key":"bibr4-1558944716677538","doi-asserted-by":"publisher","DOI":"10.1016\/j.mric.2004.02.005"},{"key":"bibr5-1558944716677538","doi-asserted-by":"publisher","DOI":"10.1259\/bjr\/73145885"},{"key":"bibr6-1558944716677538","doi-asserted-by":"publisher","DOI":"10.1007\/BF00198066"},{"key":"bibr7-1558944716677538","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.J.00711"},{"key":"bibr8-1558944716677538","doi-asserted-by":"publisher","DOI":"10.1016\/S0266-7681(96)80019-2"},{"key":"bibr9-1558944716677538","doi-asserted-by":"publisher","DOI":"10.1002\/jmri.23845"},{"key":"bibr10-1558944716677538","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0085359"},{"key":"bibr11-1558944716677538","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacr.2014.09.040"},{"key":"bibr12-1558944716677538","doi-asserted-by":"publisher","DOI":"10.1007\/s11999-016-4706-6"},{"key":"bibr13-1558944716677538","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhsa.2011.09.040"},{"key":"bibr14-1558944716677538","doi-asserted-by":"publisher","DOI":"10.2307\/2529310"},{"key":"bibr15-1558944716677538","doi-asserted-by":"publisher","DOI":"10.1016\/0165-1781(93)90033-D"},{"key":"bibr16-1558944716677538","doi-asserted-by":"publisher","DOI":"10.1177\/1753193410374690"},{"key":"bibr17-1558944716677538","doi-asserted-by":"publisher","DOI":"10.1007\/s00402-016-2438-4"},{"key":"bibr18-1558944716677538","doi-asserted-by":"publisher","DOI":"10.1016\/j.mric.2010.07.004"},{"key":"bibr19-1558944716677538","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhsa.2011.09.027"},{"issue":"5","key":"bibr20-1558944716677538","first-page":"1143","volume":"28","author":"Ostergaard M","year":"2001","journal-title":"J Rheumatol"},{"key":"bibr21-1558944716677538","doi-asserted-by":"publisher","DOI":"10.1148\/radiology.160.3.3737907"},{"key":"bibr22-1558944716677538","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhsa.2014.12.024"},{"key":"bibr23-1558944716677538","doi-asserted-by":"publisher","DOI":"10.1016\/0363-5023(90)90007-E"},{"key":"bibr24-1558944716677538","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhsa.2015.10.014"},{"key":"bibr25-1558944716677538","doi-asserted-by":"publisher","DOI":"10.1016\/S0363-5023(09)90016-8"},{"issue":"5","key":"bibr26-1558944716677538","first-page":"360","volume":"37","author":"Viera AJ","year":"2005","journal-title":"Fam Med"}],"container-title":["HAND"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/1558944716677538","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/1558944716677538","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/1558944716677538","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T07:28:45Z","timestamp":1777447725000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/1558944716677538"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,11,30]]},"references-count":26,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2017,11]]}},"alternative-id":["10.1177\/1558944716677538"],"URL":"https:\/\/doi.org\/10.1177\/1558944716677538","relation":{},"ISSN":["1558-9447","1558-9455"],"issn-type":[{"value":"1558-9447","type":"print"},{"value":"1558-9455","type":"electronic"}],"subject":[],"published":{"date-parts":[[2016,11,30]]}}}