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Observer agreement on the Dejour trochlear dysplasia classification: a comparison of true lateral radiographs and axial magnetic resonance images.
[trochlear dysplasia]
Trochlear
dysplasia
is
known
to
be
an
important
cause
of
patellofemoral
instability
.
D
.
Dejour
's
radiographic
and
magnetic
resonance
imaging
(
MRI
)
classifications
are
widely
used
in
clinical
practice
and
in
the
orthopaedic
literature
to
assess
the
severity
of
trochlear
dysplasia
.
The
indication
for
deepening
trochleoplasty
to
treat
trochlear
dysplasia
is
also
mainly
based
on
the
severity
of
trochlear
dysplasia
according
to
Dejour
's
criteria
.
To
our
knowledge
,
there
is
no
study
evaluating
the
efficacy
of
the
Dejour
classification
.
The
aim
of
this
study
was
to
assess
the
intraobserver
and
interobserver
agreements
of
the
radiographic
and
MRI-based
classification
as
described
by
Dejour
.
Cohort
study
(
diagnosis
)
;
Level
of
evidence
,
2
.
From
50
patients
,
50
lateral
radiographs
as
well
as
50
MRI
scans
were
read
twice
independently
within
4
weeks
by
4
surgeons
(
2
senior
and
2
junior
examiners
)
.
Analysis
was
made
according
to
Dejour
's
4
grades
of
radiological
criteria
of
trochlear
dysplasia
as
well
as
differentiating
between
2
grades
:
low
-grade
(
type
A
)
and
high
-grade
trochlear
dysplasia
(
types
B-D
)
.
The
4
-
grade
analysis
showed
fair
intraobserver
and
interobserver
agreements
(
24
%
-
78
%
)
,
while
the
2
-
grade
analysis
showed
good
to
excellent
agreement
(
56
%
-
96
%
)
.
The
best
overall
agreement
was
found
for
the
2
-
grade
analysis
on
MRI
scans
(
62
%
-
96
%
)
.
The
lateral
radiographs
tended
to
underestimate
the
severity
of
trochlear
dysplasia
compared
with
axial
MRI
.
D
.
Dejour
's
classification
is
valid
for
typing
trochlear
dysplasia
and
is
particularly
useful
in
separating
low
-grade
from
high
-grade
dysplasia
.
Diseases
Validation
Diseases presenting
"high-grade trochlear dysplasia"
symptom
trochlear dysplasia
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