Correlation between ultrasonic and radiographic imaging of developmental dysplasia of the hip

Spaans, Anne J.; Beek, F. J. A.; Uiterwaal, Cuno S.P.M.; Pruijs, J. E. H.; Sakkers, R. J. B.

doi:10.1302/1863-2548.13.180165

Cited by 14 publications

(17 citation statements)

References 22 publications

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“…Spaans et. al analyzed US and XR performed on the same day in 74 infants being treated for stable DDH [24]. Counter to our results, they found that US was able to diagnose DDH in more hips than XR.…”

Section: Discussionsupporting

confidence: 71%

Does a Normal Hip Ultrasound at 3-6 Months of Age Predict a Normal X-ray?

Upasani¹

2021

J Orth Rheumatol

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Objective: Ultrasound (US) may be used to diagnose/monitor developmental dysplasia of the hip (DDH) prior to femoral head ossification, after that, radiographs (XR) may become a better choice. The objective of this study was to compare US to XR performed on the same day for diagnosis or monitoring of DDH in patients 3 to 6 months of age.Methods: 92 patients (183 hips) ages 3 to 6 months who were seen for hip screening for DDH were retrospectively reviewed. All patients had a same-day hip ultrasound and plvis radiograph. Alpha angle, hip stability, femoral head coverage, acetabular index (AI), IHDI grade, and break in Shenton's line were recorded and used to diagnose the hip as normal or dysplastic.Results: 17.5% of hips were diagnosed with DDH based on XR, 12% of hips were diagnosed with DDH on US. Thirteen hips were read as normal on US but dysplastic on XR. Using XR as the definitive diagnosis, US had sensitivity of 59% and specificity of 98%. Using US as the definitive diagnosis, XR had sensitivity of 86% and specificity of 92%. Conclusion:In the 3-6 month age group, US alone may underdiagnose hip dysplasia and be inadequate to guide treatment decisions. In this age group, we suggest that pelvis radiographs be used when deciding to either initiate or conclude DDH treatment based on the higher sensitivity of the exam.

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Section: Discussionsupporting

confidence: 71%

Does a Normal Hip Ultrasound at 3-6 Months of Age Predict a Normal X-ray?

Upasani¹

2021

J Orth Rheumatol

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“…A few studies have compared ultrasound and radiographs in infants. 16 As shown in Legg-Calvé-Perthes disease, ultrasound is able to detect transient synovitis and an irregular contour of the femoral head. In patients with fragmentation, the altered bone structure is visualized.…”

Section: Discussionmentioning

confidence: 98%

Ultrasound as a diagnostic tool for femoral head containment disorders in children between one and 12 years of age

Berger-Groch

Jandl

Strahl

et al. 2021

Journal of Children's Orthopaedics

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Purpose Ultrasound has been used to diagnose hip dysplasia in neonates and to screen until the end of their first year. For older children, femoral head containment disorders such as developmental dysplasia of the hip, Legg-Calvé-Perthes disease or cerebral palsy are usually diagnosed with plain radiographs. The aim of the present study was to evaluate ultrasound in comparison with radiographic imaging in children up to age 12 years and to determine reference values for sonographic containment parameters. Methods Hip ultrasound and radiographic imaging were acquired on the same day and then compared. As a reference, normal acetabular angle and acetabulum head index were determined on radiographs. Lateral cartilage distance (LCD), lateral head distance (LHD) and femoral head extrusion angle (HA) were measured on ultrasound images. Results We included 96 patients with 167 healthy hips in the study. A total of 55 patients were female and 41 male. The mean age was 5.2 years (sd 3.3; 1.0 to 11.9). LCDultrasound, LHDultrasound and HAultrasound correlated significantly with radiographic parameters. The following ultrasound values were calculated as limits for impending loss of containment: LCDultrasound ≥ 6.5 mm, LHDultrasound ≥ 3.3 mm and HAultrasound ≥ 27.6°. Conclusion Ultrasound is a simple, radiation-free diagnostic tool to detect femoral head containment disorders, even in children older than one year. This study provides reference values for hip ultrasound in children up to 12 years. Level of evidence III

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“…However, there are disadvantages to radiography for the evaluation of DDH, including the risk of radiation and that only bony structures can be seen. In the first months of life, most bony parts of the femoral head and acetabulum remain cartilaginous, which limits the use of plain radiographs for the diagnosis in infants younger than 6 months (2). Therefore, hip sonography has become important in diagnosis, especially in the first six months of an infant's life.…”

Section: Introductionmentioning

confidence: 99%

GKD için Taranan Bebeklerde Kalça Ultrasonografisinde İki Farklı Projeksiyondaki Açı Ölçümleri Teşhisi Değiştirir mi?

Günay¹,

Aynaci²

2021

Osmangazi̇ Journal of Medicine

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Hip ultrasonography with the Graf method is used worldwide. Four different projections can be used for the evaluation of sonographic images. The best projection with the lowest rate of wrong interpretation is the "standing-up right"-projection and the worst is the ''horizontal-cranial left'' projection. The aim of this study was to show the concordance of two researchers using these two different projections. Hip sonographic evaluation according to the Graf method was applied to 166 infants (332 hips) comprising 84 males (50.6%) and 82 females (49.4%). The hip sonographic images were obtained in both the standing-up right and horizontal-cranial left projections. Two researchers independently measured the alpha and beta angles manually with a goniometer and classified the hip type. The alpha, beta angle measurement values, comparisons of the angles in both projections and for both researchers are presented in detail in Tables 1 and 2. The inter-observer agreement of the Graf types of hips was as follows; Graf types between researcher 1 and 2, Right hip-(standing-up right) Kappa value 0.84, Left hip-(standing-up right) Kappa value 0.77, Right hip-(horizontal-cranial left) Kappa value 0.67, Left hip-(horizontal-cranial left) Kappa value 0.64. The intraclass correlation coefficient (ICC) values of the agreement between the two researchers for all the measured hip angles were as follows; right angle ICC: 0.96, right angle ICC: 0.91, left angle ICC: 0.93, and left angle ICC: 0.59. Although the standing-up right projection is known to be the best projection with the lowest rate of wrong interpretation according to the Graf guidelines, the results of this study showed the evaluation of similar Graf hip types on the two projections. Therefore, the horizontal cranial left projection, which is considered to be the worst of the four projections, can be used safely for hip evaluation if the Graf checklist is followed appropriately.

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Correlation between ultrasonic and radiographic imaging of developmental dysplasia of the hip

Cited by 14 publications

References 22 publications

Does a Normal Hip Ultrasound at 3-6 Months of Age Predict a Normal X-ray?

Does a Normal Hip Ultrasound at 3-6 Months of Age Predict a Normal X-ray?

Ultrasound as a diagnostic tool for femoral head containment disorders in children between one and 12 years of age

GKD için Taranan Bebeklerde Kalça Ultrasonografisinde İki Farklı Projeksiyondaki Açı Ölçümleri Teşhisi Değiştirir mi?

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