Defining a reference range of acetabular inclination and center-edge angle of the hip in asymptomatic individuals

Fowkes, Lucy; Petridou, Elia; Zagorski, Christopher; Karuppiah, Amanjot; Toms, Andoni P.

doi:10.1007/s00256-011-1109-3

Cited by 18 publications

(18 citation statements)

References 27 publications

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“…This projection error on radiographs can be eliminated on MRI, thus supporting the use of MRI for morphometric assessment of the hip. Fourth, the radiographic measurement reproducibility data reported in the literature suggest only moderate to good reproducibility of measurements [1,11,27,29,32], what may be a limitation to our study. Sixth, patient positioning on MRI and radiography also might affect our results.…”

Section: Discussionmentioning

confidence: 70%

Can Radiographic Morphometric Parameters for the Hip Be Assessed on MRI?

Stelzeneder

Hingsammer

Bixby

et al. 2013

Clinical Orthopaedics &Amp; Related Research

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Background Although morphometric hip parameters measured on radiographs are valuable tools guiding diagnosis and therapy in patients with hip disorders, some clinicians use MRI for such measurements, although it is unclear whether the parameters assessed on MRI differ from those assessed on radiographs. Questions/purposes We asked whether the lateral centeredge angle (LCE), Tönnis angle, extrusion index, and anterior center-edge angle (ACE) are similar on MRI and radiography. Methods We retrospectively reviewed the imaging data of 103 hips from 103 patients: 46 with femoroacetabular impingement and 57 with hip dysplasia. We manually measured the LCE, Tönnis angle, extrusion index, and ACE from radiographs and MRI in all 103 hips. Four straight coronal (Ant-10 mm, Ant-5 mm, Center, and Post-5 mm), three straight sagittal (S-Med-5 mm, S-Center, S-Lat-5 mm), and three 258 oblique sagittal (OS-Med-5 mm, OS-Center, OS-Lat-5 mm) reformats were reconstructed from a three-dimensional isotropic morphologic MRI sequence. MRI measurements were compared against the gold standard radiographic measurements. Results We found good agreement for the LCE angle, Tönnis angle, and extrusion index between radiographic and coronal slice MRI measurements. The mean differences between radiographic and MRI measurements were 58 or less or 5% or less (for the extrusion index) in all coronal MRI slices. However, the differences between ACE angles on sagittal MRI slices and radiographs ranged from 5°to 288. Conclusions LCE, Tönnis angle, and extrusion index can be measured on MRI with comparable results to radiography. The ACE angle on radiographs cannot be estimated reliably from MRI. Clinical Relevance MRI provides similar morphometric measurements as radiography for most hip parameters, except for the ACE angle.

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Section: Discussionmentioning

confidence: 70%

Can Radiographic Morphometric Parameters for the Hip Be Assessed on MRI?

Stelzeneder

Hingsammer

Bixby

et al. 2013

Clinical Orthopaedics &Amp; Related Research

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“…Rotation in the axial and sagittal plane of anteroposterior pelvic radiographs may significantly change outcome measurements of coxometric indices [5,6]. In order to minimize this error, the criteria of Siebenrock et al [7] were applied to determine those cases to be further assessed.…”

Section: Validation Of Radiographsmentioning

confidence: 99%

“…However, few studies, with relatively small sample sizes [6], exist that quantify Wiberg's and Lequesne's angles using a reliable, standardized measurement procedure of the anteroposterior pelvic radiographs as previously described [7].…”

Section: Introductionmentioning

confidence: 99%

Normal values of Wiberg’s lateral center-edge angle and Lequesne’s acetabular index–a coxometric update

et al. 2012

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Background The historical pathological cut-off values for Wiberg's lateral center-edge (LCE) angle and Lequesne's acetabular index (AI) are below 20°and above 12°for the LCE and AI, respectively. The aim of this study was to reassess these two angles more than 50 years after their introduction using a standardized conventional radiological measurement method, considering changing social habits and their associated physiological changes. Methods A total of 1,226 anteroposterior radiographs of the pelvis (2,452 hips) were obtained according to a strict standardized radiographic technique allowing reliable measurements of the LCE angle and the AI. Results Distributions of the LCE and AI were pronouncedly Gaussian, with mean values of 33.6°for the LCE and 4.4°for the AI. The 2.5th and 97.5th empirical percentiles were 18.1 and 48.0°for the LCE and −6.9 and 14.9°for the AI. These intervals contained 95 % of the data in our large sample. Small but statistically significant differences between the sexes and right and left hips have been demonstrated. Correlation between age and coxometric indices was low. Conclusion The above findings do not conflict with the historical benchmarks. Statistical differences between sexes and between right and left hips were not clinically relevant. No conclusion can be drawn about coxometric indices and clinical manifestations of hip dysplasia.

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“…Abnormalities of morphologic features that can lead to FAI include cam abnormality on the femoral side and/or pincer overcoverage on the acetabular side [15,33]. Normal parameters for both of these have been defined for plain radiography and advanced imaging [2,5,7,14,19,29,35,37,41]. The alpha angle, Each author certifies that he or she has no commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article.…”

Section: Introductionmentioning

confidence: 99%

Does Femoral Rotation Influence Anteroposterior Alpha Angle, Lateral Center-edge Angle, and Medial Proximal Femoral Angle? A Pilot Study

Monazzam

Bomar

Agashe

et al. 2013

Clinical Orthopaedics &Amp; Related Research

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Background Femoral rotation on AP radiographs affects several parameters used to assess morphologic features of the proximal femur but its effect on femoroacetabular impingement parameters remains unknown. Question/purposes We therefore evaluated and characterized the potential effect of femoral rotation on (1) AP alpha angle, (2) lateral-center edge angle (LCEA), and (3) medial proximal femoral angle (MPFA) on AP hip radiographs. Methods We took seven AP hip radiographs at intervals of successive femoral rotation on a single dry, cadaveric specimen: 60°, 40°, and 20°internal rotation; 0°neutral/ anatomic rotation; and 20°, 40°, and 50°external rotation. The AP alpha angle, LCEA, and MPFA were measured on all radiographs by two independent evaluators.Results Within the range of femoral rotation studied, the AP alpha angle ranged from 39°to 62°, the LCEA from 25°to 35°, and the MPFA from 70°to 115°. MPFA and AP alpha angle showed a linear relationship with femoral rotation. Each additional degree of internal rotation produced a reciprocal reduction of the MPFA by 0.36°and the AP alpha angle by 0.18°and vice versa in external rotation. The LCEA, especially within the internal rotation range, showed minimal variation. Conclusions These changes in radiographic parameters emphasize the importance of femoral rotation and patient positioning. We recommend radiographs be evaluated for excessive femoral rotation or nonstandardized positioning before interpretation for diagnostic and treatment implications. It may be prudent to repeat radiographs in these circumstances or, when standardized positioning is not feasible, proceed toward advance imaging.

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Defining a reference range of acetabular inclination and center-edge angle of the hip in asymptomatic individuals

Abstract: The results of this study define reference ranges of two common measures of acetabular morphology and confirm statistically significant differences between men and women.

Cited by 18 publications

References 27 publications

Can Radiographic Morphometric Parameters for the Hip Be Assessed on MRI?

Can Radiographic Morphometric Parameters for the Hip Be Assessed on MRI?

Normal values of Wiberg’s lateral center-edge angle and Lequesne’s acetabular index–a coxometric update

Does Femoral Rotation Influence Anteroposterior Alpha Angle, Lateral Center-edge Angle, and Medial Proximal Femoral Angle? A Pilot Study

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