ORIGINAL ARTICLE Impact of specialty and level of training on CT measurement of femoral version: an interobserver agreement analysis

Background To determine the interobserver agreement on femoral version measurements between an orthopedic attending, orthopedic senior and junior residents, and an attending radiologist. Materials and methods Postoperative computed tomog-raphy (CT) scanograms of 267 patients who underwent femoral intramedullary (IM) nailing with corresponding radiology attending reads for femoral version were col-lected and de-identified. Femoral version measurements performed by a trauma fellowship-trained attending orthopedic surgeon (ORTHO), a senior orthopedic resident (PGY4), a junior orthopedic resident (PGY1), and a mus-culoskeletal fellowship-trained attending radiologist (RADS) were compared via Pearson’s interclass correla-tion coefficient to assess interobserver level of agreement. Results Version measurements provided by the two attending physicians exhibited the highest level of agree-ment (r = 0.661, p \ 0.01). The orthopedic attending and the senior resident had the next highest level of agreement (r = 0.543, p \ 0.01). The first-year orthopedic resident had the weakest agreement across the board: with the orthopedic attending, the radiology attending, and the senior resident. Conclusion Regardless of specialty, experience and higher levels of training produce stronger agreement when measuring femoral version. Residents in training, espe-cially those who are junior, produce weak agreement when compared to their senior colleagues. Level of evidence Level III, diagnostic study