Influence of patient rotational malpositioning on pelvic parameters assessed on lateral radiographs

Assi, Ayman; Bakouny, Ziad; Sauret, Christophe; Saghbini, Elie; Khalil, Nour; Chelala, Lydia; Naoum, Emily E.; Yared, Fares; Skalli, W.; Ghanem, Ismat

doi:10.1016/j.crad.2017.03.021

Cited by 2 publications

(5 citation statements)

References 22 publications

(19 reference statements)

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“…Most studies concerning potential contributors to the misinterpretation of hip parameters have focused on the pelvis, with little research on the femur. [9][10][11][12]28,29 Similar to our results, one cadaver study found a slight variation in the CEA (Δ ≤ 5°) with femoral rotation and even less variation with internal rotation. 6 And the author claimed no clear relationship between them, which differs from the current study.…”

Section: Notesupporting

confidence: 90%

“…Although the effect of pelvic misalignment on acetabular coverage has been extensively investigated, 9–12 few studies have quantified the impact of femoral malposition. Assessing the effect of femoral malposition on acetabular coverage remains a significant challenge for diagnosing hip conditions in children.…”

Section: Introductionmentioning

confidence: 99%

“…However, nonstandard radiographs with pelvic or femoral malpositions are common in clinical practice, 7,8 as it is challenging to secure younger children in a specific supine position. 9 Although the effect of pelvic misalignment on acetabular coverage has been extensively investigated, [9][10][11][12] few studies have quantified the impact of femoral malposition. Assessing the effect of femoral malposition on acetabular coverage remains a significant challenge for diagnosing hip conditions in children.…”

mentioning

confidence: 99%

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Quantification of femoral position on radiographic acetabular coverage in children

Sha

Yan

et al. 2022

Journal Orthopaedic Research

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An accurate assessment of the radiographic acetabular coverage is essential for clinical diagnosis or surgical decision‐making in hip disorders. This study aimed to evaluate the effect of femoral position on acetabular coverage and to predict the actual acetabular coverage from nonstandard radiographs. A total of 21 children (34 hips) with normative acetabular coverage were screened in this retrospective study. The Mimics‐based local‐rotation fluoroscopy simulation method was used to tilt, incline, and rotate the femur in 4° increments within the range of femoral motion. The acetabular coverage, namely acetabular‐head index (AHI) and center‐edge angle (CEA), increased with femoral abduction but decreased with other motions. Compared to the femoral neutral position, no significant differences were identified in AHI with the rotation (range: 0°–16°) and in CEA with the tilt (range: −20°–4°), inclination (range: 0°–4°), or rotation (range: −8°–40°). The linear regression analysis showed that the CEA increased by about 0.20° for each 1° increase in femoral inclination and decreased by about 0.01°, 0.07°, 0.06°, or 0.07° for each 1° increase in internal rotation, external rotation, flexion, or extension, respectively. And a more significant change in AHI was observed. All femoral malpositions, especially the inclination, affected radiographic acetabular coverage in children. Therefore, each pelvic radiograph should assess potential femoral malpositioning before diagnosing hip disorders. This study will assist surgeons in predicting the acetabular coverage on nonstandard radiographs.

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Section: Notesupporting

confidence: 90%

Section: Introductionmentioning

confidence: 99%

mentioning

confidence: 99%

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Quantification of femoral position on radiographic acetabular coverage in children

Sha

Yan

et al. 2022

Journal Orthopaedic Research

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“…The measurement errors obtained with the EOS in the present study were smaller than those reported in studies using radiography 37 – 40 , indicating that the EOS is one of the most accurate and reliable modalities currently available for the measurement of pelvic orientation and parameters of the pelvis in various functional positions. However, the results of the present study still indicate that correct positioning of patients is required to minimize measurement errors of pelvic parameters and orientation, even with the EOS.…”

Section: Discussioncontrasting

confidence: 58%

“…Measurements of pelvic orientation and parameters in simple radiography are known to be affected by the position of the pelvis, as a point source of X-rays is used to make a projection image 37 – 40 . As measurements on the biplanar stereoradiograph reflect 3D coordinates of the pelvis, the positional effects are expected to be negligible on measurements of pelvic orientation and parameters.…”

Section: Introductionmentioning

confidence: 99%

Validity of the EOS-determined pelvic parameters and orientation with pelvic positional variation: a phantom study

Kim

Lee²,

Lee

et al. 2021

Sci Rep

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The EOS is a medical imaging system that incorporates simultaneous orthogonal images, producing three-dimensional (3D) reconstructions of the whole skeletal system in various functional positions. Despite growing interest in the pelvic 3D position, the validity of the EOS has not yet been well studied. We investigated the trueness and precision of EOS imaging for pelvic parameters and orientation and assessed whether the measurement using the EOS was affected by the pelvic orientation itself. The orientation of the anterior pelvic plane and pelvic parameters of a custom-made pelvic phantom were measured by three raters using the EOS, and the measurements obtained were compared with the true values. The standard deviations of the measurement errors were 3.23°, 0.26°, 0.23°, 2.98°, 0.88°, and 3.22° for flexion, obliquity, rotation, pelvic incidence, spinopelvic tilt, and sacral slope, respectively. The root-mean square averages of the standard deviation of each measurement were 4.05°, 0.41°, 0.28°, 4.80°, 0.99°, and 5.13°, respectively. The measurement errors for sacral slope correlated significantly with geometric means of flexion, obliquity, and rotation (r = 0.364, p = 2.67 × 10–11). The EOS rendered accurate and reliable measurements regarding pelvic 3D position, even with positional variation, but positional variation could affect measurements of sacral slope.

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Influence of patient rotational malpositioning on pelvic parameters assessed on lateral radiographs

Abstract: AR of patients during radiograph acquisition can be estimated in clinical practice, which would allow physicians to discard any radiographs where the calculated AR exceeded 10°.

Cited by 2 publications

References 22 publications

Quantification of femoral position on radiographic acetabular coverage in children

Quantification of femoral position on radiographic acetabular coverage in children

Validity of the EOS-determined pelvic parameters and orientation with pelvic positional variation: a phantom study

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