Shoulder MRI parameters in anticipating anterior shoulder dislocation: Are they a reliable and reproducible tool in clinical practice?

BACKGROUND: Anterior shoulder dislocation (ASD) is a frequently observed musculoskeletal injury that is often encountered in the context of sports activities or as a result of trauma. Several magnetic resonance imaging (MRI) parameters have been previously investigated for the purpose of characterizing the anatomical features, which could potentially be responsible for the episodes of instability. These measurements have the potential to identify patients who are susceptible to dislocation. Consequently, ensuring the reliability and consistency of these measurements is crucial in the diagnosis and the management of athletic or traumatic shoulder injuries. METHODS: A group of four students, who had no previous experience in reading MRI series, were selected to perform radiographic measurements on specific parameters of MRI scans. These parameters were glenoid version, glenoid depth, glenoid width, humeral head diameter, humeral containing angle, and the ratio of humeral head diameter to glenoid diameter. The four participants conducted two distinct readings on a total of 28 sets of shoulder MRI scans. Simultaneously, the aforementioned measures were assessed by a consultant shoulder surgeon. RESULTS: A total of 1512 measurements were categorized into nine sets: eight from students' measurements (two per student) and one from the consultant. Intra-rater reliability assessed by the intra-class correlation (ICC) test indicated excellent or good reliability for all parameters (p < 0.05), with glenoid depth showing the highest (0.925) and humeral-containing angles the lowest (0.675) ICC value. Inter-rater correlation, also evaluated using ICC, demonstrated strong correlation (p < 0.05), with glenoid diameter having the highest ICC score (0.935) and glenoid depth the lowest (0.849). Agreement analysis, expressed by Cohen's Kappa test, revealed substantial agreement (p < 0.05) for all parameters, with humeral head diameter having the highest agreement (0.90) and humeral-containing angle the lowest (0.73). CONCLUSION: In this study, intra- and inter-rater MRI parameters are substantially concordant. Credibility comes from these reliability and agreement analyses' statistical significance. Glenoid diameter and depth are the most reliable intrarater and interrater, respectively. Best agreement was with the humeral-containing angle. These data demonstrate repeatability and clinical relevance. LEVEL OF EVIDENCE: Level IV.

Burnout, grit and resilience among Jordanian orthopedic surgeons: a cross-sectional study.

BACKGROUND: Burnout is a serious issue that affects physicians more than the general population; however, those with higher levels of grit and resilience have been shown to experience lower levels of burnout. The primary aim was to determine the prevalence of burnout among Jordanian orthopedic surgeons, explore its risk factors, and investigate the relationship between burnout and grit and resilience. METHODS: We conducted a questionnaire-based cross-sectional study targeting a total of 180 orthopedic surgeons attending the yearly Jordanian National Orthopedic Conference (JNOC). Non-random sampling (i.e., convenience) was utilized to recruit participants. The abbreviated Maslach Burnout Inventory, short grit scale, and Connor-Davidson Resilience Scale were used. Scores were examined using the Mann-Whitney U, Kruskal-Wallis H, and Spearman's rho tests, of which results were corrected using the Bonferroni method. RESULTS: Among 135 respondents, 62.2% were specialists and 37.8% were residents. About 52.0% practiced in public hospitals. Approximately 69.0% worked for more than 50 h weekly. The prevalence of burnout among all participants was 45.2% with more frequency among residents (66.7%). Burnout and the participants' grit and resilience showed an inverse relationship (ρ = -0.441 and ρ = -0.312, respectively). Age (ρ = 0.337), number of children (ρ = 0.245), and years of experience (ρ = 0.331) were positively correlated with grit. The median score for grit was higher in physicians who had or are having their residency outside Jordan (p < 0.001). Age (ρ = 0.233) and years of experience (ρ = 0.269) were positively correlated with resilience. CONCLUSION: Jordanian orthopedic surgeons face significant rates of burnout. Institutional efforts should be taken to detect and prevent burnout in addition to enhancing the grit and resilience among orthopedic professionals.