{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,6,11]],"date-time":"2025-06-11T19:10:04Z","timestamp":1749669004263,"version":"3.41.0"},"reference-count":31,"publisher":"National Athletic Trainers' Association","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2014,1,1]]},"abstract":"<jats:sec><jats:title>Context:<\/jats:title><jats:p>Epicondylalgia is a common condition involving pain-generating structures such as tendon, neural, and chondral tissue. The current noninvasive reference standard for identifying chondral lesions is magnetic resonance imaging. Musculoskeletal ultrasound (MUS) may be an inexpensive and effective alternative.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective:<\/jats:title><jats:p>To determine the intrarater reliability and validity of MUS for identifying humeroradial joint (HRJ) chondral lesions.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design:<\/jats:title><jats:p>Cross-sectional study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting:<\/jats:title><jats:p>Clinical anatomy research laboratory.<\/jats:p><\/jats:sec><jats:sec><jats:title>Patients or Other Participants:<\/jats:title><jats:p>Twenty-eight embalmed cadavers (14 women, 14 men; mean age = 79.5 \u00b1 8.5 years).<\/jats:p><\/jats:sec><jats:sec><jats:title>Main Outcome Measure(s):<\/jats:title><jats:p>An athletic trainer performed MUS evaluation of each anterior and distal-posterior capitellum and radial head to identify chondral lesions. The reference standard was identification of chondral lesions by gross macroscopic examination. Intrarater reliability for reproducing an image was calculated using the intraclass correlation coefficient (3,k) for measurements of the articular surface using 2 images. Intrarater reliability to evaluate a single image was calculated using the Cohen \u03ba for agreement as to the presence of chondral lesions. Validity was calculated using the agreement of MUS images and gross macroscopic examination.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results:<\/jats:title><jats:p>Intrarater reliability was 0.88 (95% confidence interval = 0.77, 0.94) for reproducing an image and 0.93 (95% confidence interval = 0.80, 1.06) for evaluating a single image. Identifying chondral lesions on all HRJ surfaces with MUS demonstrated sensitivity = 0.93, specificity = 0.28, positive predictive value = 0.58, negative predictive value = 0.77, positive likelihood ratio = 1.28, and negative likelihood ratio = 0.27.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions:<\/jats:title><jats:p>Musculoskeletal ultrasound is a reliable and sensitive tool for a clinician with relatively little experience and training to rule out HRJ chondral lesions. These results may assist with clinical assessment and decision making in patients with lateral epicondylalgia to rule out HRJ chondral lesions.<\/jats:p><\/jats:sec>","DOI":"10.4085\/1062-6050-49.1.03","type":"journal-article","created":{"date-parts":[[2013,12,30]],"date-time":"2013-12-30T15:40:28Z","timestamp":1388418028000},"page":"7-14","source":"Crossref","is-referenced-by-count":1,"title":["Validity of Musculoskeletal Ultrasound for Identification of Humeroradial Joint Chondral Lesions: A Preliminary Investigation"],"prefix":"10.4085","volume":"49","author":[{"given":"Chelsea M.","family":"Lohman","sequence":"first","affiliation":[{"name":"Center for Rehabilitation Research, Texas Tech University Health Sciences Center, Lubbock"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael P.","family":"Smith","sequence":"first","affiliation":[{"name":"Department of Biology, The Sage Colleges, Troy, NY"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gregory S.","family":"Dedrick","sequence":"first","affiliation":[{"name":"College of Pharmacy and Health Sciences, Campbell University, Buies Creek, NC"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jean-Michel","family":"Brism\u00e9e","sequence":"first","affiliation":[{"name":"Center for Rehabilitation Research, Texas Tech University Health Sciences Center, Lubbock"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2557","reference":[{"issue":"4","key":"2020060411165571100_i1062-6050-49-1-7-b01","doi-asserted-by":"crossref","first-page":"679","DOI":"10.1016\/S0033-8389(05)70123-8","article-title":"Detection of loose bodies in joints","volume":"37","author":"Bianchi","year":"1999","journal-title":"Radiol Clin North Am"},{"issue":"1","key":"2020060411165571100_i1062-6050-49-1-7-b02","doi-asserted-by":"crossref","first-page":"175","DOI":"10.1302\/0301-620X.49B1.175","article-title":"The pattern of ageing of the articular cartilage of the elbow joint","volume":"49","author":"Goodfellow","year":"1967","journal-title":"J Bone Joint Surg Br"},{"issue":"4","key":"2020060411165571100_i1062-6050-49-1-7-b03","doi-asserted-by":"crossref","first-page":"301","DOI":"10.1007\/BF01795186","article-title":"A topographical study of cartilaginous lesions to the elbow","volume":"17","author":"Debouck","year":"1995","journal-title":"Surg Radiol Anat"},{"issue":"1","key":"2020060411165571100_i1062-6050-49-1-7-b04","doi-asserted-by":"crossref","first-page":"52","DOI":"10.1067\/mse.2001.109382","article-title":"Patterns of articular wear in the cadaveric elbow joint","volume":"10","author":"Ahrens","year":"2001","journal-title":"J Shoulder Elbow Surg"},{"issue":"1","key":"2020060411165571100_i1062-6050-49-1-7-b05","first-page":"37","article-title":"Lateral compartment cartilage changes and lateral elbow pain","volume":"75","author":"Rajeev","year":"2009","journal-title":"Acta Orthop Belg"},{"issue":"2","key":"2020060411165571100_i1062-6050-49-1-7-b06","doi-asserted-by":"crossref","first-page":"151","DOI":"10.2165\/00007256-200636020-00005","article-title":"Epicondylar injury in sport: epidemiology, type, mechanisms, assessment, management and prevention","volume":"36","author":"Hume","year":"2006","journal-title":"Sports Med"},{"issue":"1","key":"2020060411165571100_i1062-6050-49-1-7-b07","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1016\/S0278-5919(20)30258-1","article-title":"Elbow injuries","volume":"14","author":"Field","year":"1995","journal-title":"Clin Sports Med"},{"issue":"2","key":"2020060411165571100_i1062-6050-49-1-7-b08","doi-asserted-by":"crossref","first-page":"115","DOI":"10.1007\/s00256-007-0364-9","article-title":"MR imaging of the elbow in baseball pitchers","volume":"37","author":"Ouellette","year":"2008","journal-title":"Skelet Radiol"},{"issue":"6","key":"2020060411165571100_i1062-6050-49-1-7-b09","doi-asserted-by":"crossref","first-page":"421","DOI":"10.2165\/00007256-199621060-00004","article-title":"Biomechanics of overhand throwing with implications for injuries","volume":"21","author":"Fleisig","year":"1996","journal-title":"Sports Med"},{"issue":"4","key":"2020060411165571100_i1062-6050-49-1-7-b10","doi-asserted-by":"crossref","first-page":"748","DOI":"10.1016\/j.jhsa.2012.01.005","article-title":"Radiocapitellar cartilage injuries associated with tennis elbow syndrome","volume":"37","author":"Sasaki","year":"2012","journal-title":"J Hand Surg Am"},{"issue":"2","key":"2020060411165571100_i1062-6050-49-1-7-b11","doi-asserted-by":"crossref","first-page":"77","DOI":"10.5435\/00124635-200802000-00005","article-title":"Primary osteoarthritis of the elbow: current treatment options","volume":"16","author":"Cheung","year":"2008","journal-title":"J Am Acad Orthop Surg"},{"issue":"5","key":"2020060411165571100_i1062-6050-49-1-7-b12","doi-asserted-by":"crossref","first-page":"1095","DOI":"10.1016\/S0033-8389(02)00034-9","article-title":"MR imaging of chondral and osteochondral injuries of the knee","volume":"40","author":"McCauley","year":"2002","journal-title":"Radiol Clin North Am"},{"issue":"5","key":"2020060411165571100_i1062-6050-49-1-7-b13","doi-asserted-by":"crossref","first-page":"560","DOI":"10.1097\/BOR.0b013e328307f272","article-title":"Ultrasonography in osteoarthritis: recent advances and prospects for the future","volume":"20","author":"Chao","year":"2008","journal-title":"Curr Opin Rheumatol"},{"issue":"suppl 3","key":"2020060411165571100_i1062-6050-49-1-7-b14","doi-asserted-by":"crossref","first-page":"S4","DOI":"10.1016\/j.joca.2008.06.005","article-title":"Ultrasound in the study and monitoring of osteoarthritis","volume":"16","author":"M\u00f6ller","year":"2008","journal-title":"Osteoarthr Cartil"},{"issue":"5","key":"2020060411165571100_i1062-6050-49-1-7-b15","doi-asserted-by":"crossref","first-page":"376","DOI":"10.1016\/j.joca.2012.01.016","article-title":"Diagnostic performance of knee ultrasonography for detecting degenerative changes of articular cartilage","volume":"20","author":"Saarakkala","year":"2012","journal-title":"Osteoarthritis Cartilage"},{"issue":"11","key":"2020060411165571100_i1062-6050-49-1-7-b16","doi-asserted-by":"crossref","first-page":"605","DOI":"10.1007\/s002560100410","article-title":"Ultrasound of the elbow","volume":"30","author":"Martinoli","year":"2001","journal-title":"Skelet Radiol"},{"issue":"2","key":"2020060411165571100_i1062-6050-49-1-7-b17","doi-asserted-by":"crossref","first-page":"58","DOI":"10.1055\/s-2007-1005217","article-title":"Ultrasound imaging of the elbow joint: loose joint bodies and osteochondrosis dissecans [in German]","volume":"14","author":"Bruns","year":"1993","journal-title":"Ultraschall Med"},{"issue":"2","key":"2020060411165571100_i1062-6050-49-1-7-b18","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1016\/j.radi.2010.08.003","article-title":"A survey of diagnostic ultrasound within the physiotherapy profession for the design of future training tools","volume":"17","author":"McKiernan","year":"2011","journal-title":"Radiography"},{"issue":"1","key":"2020060411165571100_i1062-6050-49-1-7-b19","doi-asserted-by":"crossref","first-page":"57","DOI":"10.1097\/JSM.0b013e31820758aa","article-title":"Office-based ultrasound in sports medicine practice","volume":"21","author":"Coris","year":"2011","journal-title":"Clin J Sport Med"},{"issue":"1","key":"2020060411165571100_i1062-6050-49-1-7-b20","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1097\/JSA.0b013e3181982add","article-title":"Diagnostic ultrasound in sports medicine: current concepts and advances","volume":"17","author":"Nofsinger","year":"2009","journal-title":"Sports Med Arthrosc Rev"},{"issue":"3","key":"2020060411165571100_i1062-6050-49-1-7-b21","doi-asserted-by":"crossref","first-page":"291","DOI":"10.1016\/j.jse.2004.01.017","article-title":"The use of in-office, orthopaedist-performed ultrasound of the shoulder to evaluate and manage rotator cuff disorders","volume":"13","author":"Ziegler","year":"2004","journal-title":"J Shoulder Elbow Surg"},{"issue":"7","key":"2020060411165571100_i1062-6050-49-1-7-b22","doi-asserted-by":"crossref","first-page":"641","DOI":"10.1136\/ard.60.7.641","article-title":"Guidelines for musculoskeletal ultrasound in rheumatology","volume":"60","author":"Backhaus","year":"2001","journal-title":"Ann Rheum Dis"},{"key":"2020060411165571100_i1062-6050-49-1-7-b23","unstructured":"Portney L, Watkins M. Foundations of Clinical Research: Applications to Practice. 3rd ed. Upper Saddle River, NJ: Pearson Prentice Hall;2009."},{"key":"2020060411165571100_i1062-6050-49-1-7-b24","unstructured":"Van Holsbeeck M, Introcaso J. Musculoskeletal Ultrasound. 2nd ed. St Louis, MO: Mosby;2001:15\u201320."},{"issue":"6 suppl 2","key":"2020060411165571100_i1062-6050-49-1-7-b25","first-page":"19","article-title":"Ultrasonography in osteoarthritis","volume":"34","author":"Grassi","year":"2005","journal-title":"Semin Arthritis Rheum"},{"issue":"4","key":"2020060411165571100_i1062-6050-49-1-7-b26","doi-asserted-by":"crossref","first-page":"784","DOI":"10.1007\/s00330-004-2585-9","article-title":"Comparison of multislice CT arthrography and MR arthrography for the detection of articular cartilage lesions of the elbow","volume":"15","author":"Waldt","year":"2005","journal-title":"Eur Radiol"},{"issue":"5","key":"2020060411165571100_i1062-6050-49-1-7-b27","doi-asserted-by":"crossref","first-page":"684","DOI":"10.1302\/0301-620X.87B5.14851","article-title":"The detection of loose bodies in the elbow: the value of MRI and CT arthrography","volume":"87","author":"Dubberley","year":"2005","journal-title":"J Bone Joint Surg Br"},{"issue":"2","key":"2020060411165571100_i1062-6050-49-1-7-b28","doi-asserted-by":"crossref","first-page":"215","DOI":"10.1016\/j.ejrad.2010.10.015","article-title":"Ultrasonographic evaluation of degenerative changes in the distal radioulnar joint: correlation of findings with gross anatomy and MR arthrography in cadavers","volume":"77","author":"Buck","year":"2011","journal-title":"Eur J Radiol"},{"issue":"3","key":"2020060411165571100_i1062-6050-49-1-7-b29","doi-asserted-by":"crossref","first-page":"352","DOI":"10.1016\/j.joca.2007.07.013","article-title":"The validity of in vivo ultrasonographic grading of osteoarthritic femoral condylar cartilage: a comparison with in vitro ultrasonographic and histologic gradings","volume":"16","author":"Lee","year":"2008","journal-title":"Osteoarthritis Cartilage"},{"issue":"2","key":"2020060411165571100_i1062-6050-49-1-7-b30","doi-asserted-by":"crossref","first-page":"194","DOI":"10.1016\/j.ejrad.2007.11.012","article-title":"The effectiveness of diagnostic imaging methods for the assessment of soft tissue and articular disorders of the shoulder and elbow","volume":"65","author":"Shahabpour","year":"2008","journal-title":"Eur J Radiol"},{"issue":"2","key":"2020060411165571100_i1062-6050-49-1-7-b31","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1007\/BF00316645","article-title":"The stress of the human hip joint, VI: a functional analysis of the cartilage thickness in the human femoral head [in German]","volume":"150","author":"Kurrat","year":"1977","journal-title":"Anat Embryol"}],"container-title":["Journal of Athletic Training"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/meridian.allenpress.com\/jat\/article-pdf\/49\/1\/7\/1610504\/1062-6050-49_1_03.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/meridian.allenpress.com\/jat\/article-pdf\/49\/1\/7\/1610504\/1062-6050-49_1_03.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,6,11]],"date-time":"2025-06-11T18:56:56Z","timestamp":1749668216000},"score":1,"resource":{"primary":{"URL":"https:\/\/nata.kglmeridian.com\/view\/journals\/attr\/49\/1\/article-p7.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2014,1,1]]},"references-count":31,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2014,1,1]]}},"URL":"https:\/\/doi.org\/10.4085\/1062-6050-49.1.03","relation":{},"ISSN":["1062-6050"],"issn-type":[{"type":"print","value":"1062-6050"}],"subject":[],"published":{"date-parts":[[2014,1,1]]}}}