Diagnosing Childhood Acetabular Dysplasia Using the Lateral Margin of the Sourcil

Kim, Hui Taek; Kim, Jung Il; Yoo, Chong Il

doi:10.1097/01241398-200011000-00003

Cited by 54 publications

(43 citation statements)

References 16 publications

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“…Mitani et al 21 reported a satisfactory outcome in only 67% of patients treated with the harness and no addi- 19 reported that a minimum centre-edge angle of 10˚ at five or six years of age may be a reasonable threshold of normality. However, Kim et al 27 reported that the centre-edge angle is only useful in children over the age of five years because the Anteroposterior radiograph in a five-year-old girl with bilateral developmental dysplasia of the hip treated with the Pavlik harness. The acetabular index was 34˚ on the right and 39˚ on the left.…”

Section: Discussionmentioning

confidence: 99%

“…Radiological follow-up was carried out every 6 to 12 months after the initial treatment and the plain radiograph taken a mean age of 4.9 years (3 to 7) was used to evaluate the indications for additional surgery. The acetabular index (AI) 26,27 was used as the basic indicator of residual acetabular dysplasia. Periodic examination was continued for patients with an AI < 30˚ (harness-only group), and additional surgery was indicated for those with an AI of 30˚ or more (supplementary group) ( Fig.…”

Section: Methodsmentioning

confidence: 99%

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Treatment for developmental dysplasia of the hip using the Pavlik harness

Nakamura

Kamegaya

Saisu

et al. 2007

The Journal of Bone and Joint Surgery. British volume

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We reviewed the medical records of 115 patients with 130 hips with developmental dysplasia with complete dislocation in the absence of a neuromuscular disorder, spontaneous reduction with a Pavlik harness, and a minimum of 14 years' follow-up. The mean age at the time of harness application was 4.8 months (1 to 12) and the mean time spent in the harness was 6.1 months (3 to 12). A total of 108 hips (83.1%) were treated with the harness alone and supplementary surgery for residual acetabular dysplasia, as defined by an acetabular index > 30 degrees , was performed in 22 hips (16.9%). An overall satisfactory outcome (Severin grade I or II) was achieved in 119 hips (91.5%) at a mean follow-up of 16 years (14 to 32) with a follow-up rate of 75%. Avascular necrosis of the femoral head was noted in 16 hips (12.3%), seven of which (44%) underwent supplementary surgery and nine (56%) of which were classified as satisfactory. The acetabular index was the most reliable predictor of residual acetabular dysplasia.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Treatment for developmental dysplasia of the hip using the Pavlik harness

Nakamura

Kamegaya

Saisu

et al. 2007

The Journal of Bone and Joint Surgery. British volume

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“…However, a plain radiograph cannot always be of reliable standard because of pelvic malposition during the acquisition of radiograph as well as inaccurate centralization of the X-ray beam [6][7][8]. In addition, the imprecise location of the superolateral part of the acetabulum may contribute to the measurement error [9]. The variance of AI measurement and pelvic orientation is greater in younger children who are incapable of cooperation during the examination.…”

Section: Introductionmentioning

confidence: 99%

How to judge pelvic malposition when assessing acetabular index in children? Three simple parameters can determine acceptability

et al. 2020

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Background: The acetabular index (AI) is the most commonly used parameter for diagnosing hip dysplasia. Pelvic malposition can result in misinterpretation of AI measurement especially in younger children. We aimed to investigate the correlation between pelvic orientation and acetabular index (AI) by using digital reconstructed radiographs (DRRs) and identify reliable parameters predictive of pelvic orientation on plain radiographs. Methods: We retrospectively identified 33 children (52 hips) who received dual source CT examinations. Virtual pelvic models were reconstructed after scanning. After orientating in the standard neutral position, the models were rotated and tilted around corresponding axes. DRRs were generated at every 3°during the process. The acetabular index, the horizontal diameter (Dh) and vertical diameter (Dv) of bilateral obturator foramina, the vertical distance (h) between upper border of pubic symphysis, and Hilgenreiner's line were measured on each DRR by two independent observers. Rotation index (Rr = right Dh/left Dh), tilt index (Rt = h/Dv), intra-observer error, and interobserver error of AI were calculated. Results: For tilt and rotation up to 12.0°, AI increased with anterior tilt and decreased with posterior tilt. And for rotation, it increased on the side toward which the pelvis rotated and decreased on the opposite side. AI varied dramatically if angulation exceeded 6.0°. Malposition below this limit demonstrated the intra-and inter-observer errors were ± 2.0°and ± 3.0°respectively and caused no significant effect on AI measurement. Conclusions: For children up to age 6 years, an acceptable pelvic plain radiograph can be determined when Rt is approximately between 0.9 and 1.4 and Rr between 0.7 and 1.5. For the first time, we have identified parameters derived from a group of subjects which can predict this degree of malposition. The parameters obturator diameters (Dh), obturator height (Dv), and distance (h) between symphysis and Hilgengreiner's line can be feasibly measured on X-ray and employed in clinical practice to assess the acceptability of the pediatric pelvic radiograph prior to measurement of the AI.

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“…The sourcil is a curved area of dense bone on the weight‐bearing surface of the acetabulum. Difficulty in identification of the medial margin of the sourcil to measure acetabular depth reportedly contributes to low repeatability of the AI in children 28 . AI was not highly repeatable in the most ages evaluated in this investigation in canine hips; however, the source of the difficulty in AI measurement was not likely because of identification of the sourcil in this case, because other measures that relied on identification of the landmark, the HTEA and CPC, were highly repeatable.…”

Section: Discussionmentioning

confidence: 75%

Interobserver Repeatability of Measurements on Computed Tomography Images of Lax Canine Hip Joints from Youth to Maturity

et al. 2009

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Objectives To determine interobserver repeatability of measurements on computed tomography (CT) images of lax canine hip joints at different ages and in the presence of degenerative joint disease at maturity. Study Design Longitudinal observational investigation. Animals Sibling crossbreed hounds. Methods Pelvic CT was performed at 20, 24, 32, 48, 68, and 104 weeks of age. Measures were performed on 3 contiguous two-dimensional (2D) transverse CT images of both hips at each time point by 3 investigators. Center-edge angle (CEA), horizontal toit externe angle (HTEA), ventral (VASA), dorsal (DASA), and horizontal (HASA) acetabular sector angles, acetabular index (AI), and percent femoral head coverage (CPC) were measured. Interobserver repeatability was quantified with the intraclass correlation coefficient (ICC). Satisfactory repeatability was considered when ICC ≥ 0.75. Results DASA, CEA, and CPC were repeatable in all age groups. HASA and HTEA were repeatable for all but 1 time point. At 20 weeks of age, all measures but AI were repeatable, and at 104 weeks of age, DASA, CEA, CPC, and HASA were repeatable. Measures were repeatable in hips with and without degenerative changes with the exceptions of AI and HASA in normal hips and VASA and HTEA in osteoarthritic hips. Conclusions Most 2D CT measurements examined were repeatable regardless of age or joint disease. Clinical Relevance Two-dimensional CT measures may augment current techniques for assessing joint changes in lax canine hips.

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Diagnosing Childhood Acetabular Dysplasia Using the Lateral Margin of the Sourcil

Cited by 54 publications

References 16 publications

Treatment for developmental dysplasia of the hip using the Pavlik harness

Treatment for developmental dysplasia of the hip using the Pavlik harness

How to judge pelvic malposition when assessing acetabular index in children? Three simple parameters can determine acceptability

Interobserver Repeatability of Measurements on Computed Tomography Images of Lax Canine Hip Joints from Youth to Maturity

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