Evaluation of ultrasonographic angle and linear parameters in the diagnosis of developmental dysplasia of the hip

Irha, Ernest; Vrdoljak, Javor; Vrdoljak, Ozren

doi:10.1097/01202412-200401000-00002

Cited by 3 publications

(3 citation statements)

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“…6,7 Next to Graf's method of quantification other methods and techniques have been published, however, there is no consensus about the most adequate method for quantification and classification of DDH. 4,8 The most commonly used methods for evaluation and quantification are the methods according to Graf and Morin and Terjesen. [7][8][9][10] Graf's method focuses on acetabular morphology, measuring the angle of acetabular inclination (α-angle) and the acetabular roof angle (β-angle).…”

Section: Introductionmentioning

confidence: 99%

“…4,8 The most commonly used methods for evaluation and quantification are the methods according to Graf and Morin and Terjesen. [7][8][9][10] Graf's method focuses on acetabular morphology, measuring the angle of acetabular inclination (α-angle) and the acetabular roof angle (β-angle). 7,9 Morin introduced the d/D ratio, which determines the percentage of the femoral head lying medial to the lateral iliac border, also known as the femoral head coverage (FHC) which gives an indication of the depth of the acetabulum.…”

Section: Introductionmentioning

confidence: 99%

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

Spaans

Beek

Uiterwaal

et al. 2019

Journal of Children's Orthopaedics

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Purpose The correlation between the degree of developmental hip dysplasia (DDH) measured on ultrasound images compared with that measured on radiographs is not clear. Most studies have compared ultrasonography (US) and radiographic images made at different times of follow-up. In this study the correlation between US images and radiographs of the hip made on the same day was evaluated. Methods US images and radiographs of both hips of 74 infants, who were treated for stable DDH, were reviewed in a retrospective study. Only infants who had an US examination and a radiograph on the same day were included. Results The correlation between α-angle of Graf and femoral head coverage on US was strong (p ≤ 0.0001). Weak correlations were found between the acetabular index of Tönnis on radiographs and α-angle of Graf on US (p = 0.049) and between acetabular index of Tönnis on radiographs and femoral head coverage of Morin on US (p = 0.100). Conclusion This study reports on the correlation between US and radiographic imaging outcomes, both made on the same day in patients for treatment and follow-up of DDH. Level of Evidence IV

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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

Spaans

Beek

Uiterwaal

et al. 2019

Journal of Children's Orthopaedics

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show abstract

“…The results of three different studies revealed that it was better to measure the α and β angles than to compute the FHC for precisely defining the hip morphology and managing the hip pathology [24, 28, 29].…”

Section: Consistency Of the Infantile Hip Ultrasonography Methodsmentioning

confidence: 99%

Use of ultrasonography in developmental dysplasia of the hip

Ömeroğlu

2014

Journal of Children's Orthopaedics

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PurposeUltrasonography has been used as a diagnostic tool in developmental dysplasia of the hip (DDH) during early infancy since the early 1980s. The aim of this review article is to summarise the technique, benefits and shortcomings of four infantile hip ultrasonography methods, focusing mainly on the Graf method, and to assess the effectiveness of ultrasonographic newborn hip screening programmes.MethodsSeveral infantile hip ultrasonography methods have been defined to assess the relationship between the femoral head and acetabulum. The Graf, Harcke, Terjesen and Suzuki methods are the universally known ones. The Graf method is composed of a quantitative classification system, while the Harcke and Suzuki methods have qualitative definitions and the Terjesen method contains both quantitative and qualitative descriptions.ResultsAlthough the results of several studies assessing the sensitivity and consistency of the ultrasonography methods have still not proven a clear dominance of one of these techniques, the primary advantage of the Graf method is that it has a standardised examination technique, as well as a very well defined numeric hip typing system. The importance of newborn hip screening has been universally accepted, but there is still no strong evidence regarding the superiority of either universal (screening of all newborns) or selective (screening of high-risk newborns) ultrasonographic newborn hip screening programmes.ConclusionsAn effective ultrasonographic method should include simple, precise, quantitative and consistent definitions for a proper examination and diagnosis. Both universal and selective ultrasonographic newborn hip screening programmes have significantly decreased the rate of late detected DDH and lessened the need for surgical treatment.

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Comparing ultrasound measurements of neonatal hips using the methods of Graf and Terjesen

Falliner

Schwinzer²,

Hahne³

et al. 2006

The Journal of Bone and Joint Surgery. British volume

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In a prospective study, 232 neonates were examined sonographically using the methods of Graf and Terjesen. In order to determine the reproducibility of the methods, 50 hips were evaluated by two skilled examiners. In an inter-observer study, five physicians and five medical students evaluated 24 images, which were evaluated on ten occasions at two-weekly intervals by one of the authors. Statistical evaluation used the Bland-Altman approach. The neonates (110 females, 122 males) were less than four days old. The mean alpha angle was 62.4 degrees and mean femoral head cover was 55.4%. According to Graf's method, 1.3% of hips were pathological, compared with 4.1% according to Terjesen. Spearman's correlation coefficient between femoral head cover and alpha angles was 0.552. The Bland-Altman approach shows greater variation for femoral head cover than for alpha, if measured by experienced examiners. The Bland-Altman approach shows almost equal reproducibility for alpha and femoral head cover in the inter-observer test, but better repeatability for alpha in the intra-observer test. The Graf results relate better than Terjesen's to the well-known frequency of 1% to 2% hip dysplasia in the European population. Kappa statistics indicate a fair agreement between the two methods. Inter-observer evaluation shows an equal reproducibility of both methods, whereas intra-observer tests reveal better repeatability with Graf's method.

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Evaluation of ultrasonographic angle and linear parameters in the diagnosis of developmental dysplasia of the hip

Cited by 3 publications

References 12 publications

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

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

Use of ultrasonography in developmental dysplasia of the hip

Comparing ultrasound measurements of neonatal hips using the methods of Graf and Terjesen

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