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Visual estimation of joint angles at the elbow

Abu-Rajab, R.B. and Marsh, A. and Young, D. and Rymaszewski, L.A. (2010) Visual estimation of joint angles at the elbow. European Journal of Orthopaedic Surgery and Traumatology, 20 (6). pp. 463-467. ISSN 1633-8065

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The aim of this study was to assess the accuracy of visual estimation of elbow joint angles. A total of 116 observers (93 doctors and 23 physiotherapists) were shown 21 digital images of two arms in predeWned degrees of elbow Xexion on two separate occasions. They estimated the angle of Xexion to the nearest 5°. Only 70.8% of estimates were within +5°, although intra-observer agreement was good among all groups tested (ICC range 0.963- 0.983). Orthopaedic consultants and registrars were equivalent and statistically better at estimating the angles compared to senior house oYcers and physiotherapists (P < 0.001). Compared to the angles of 85 and 90°, all other angles were signiWcantly less likely to be estimated to within +5° (P < 0.001). In conclusion, visual estimation of joint angles at the elbow may not be desirable in cases where accurate serial assessment is required for clinical decision making. The use of a goniometer by an agreed standardized protocol is advised.