Measuring the Acetabular Index: An Accurate and Reliable Alternative Method of Measurement

Sherman, Benjamin; Lalonde, François; Schlechter, John A.

doi:10.2214/ajr.20.23358

Cited by 6 publications

(10 citation statements)

References 17 publications

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“…Previous studies revealed that DDH began with a shallow acetabulum and anteverted femur ( 8 , 42 ). Sherman et al found AI was an objective and preferred index for diagnosing hip dysplasia in children under eight ( 43 ). Davila-Parrilla et al observed AI was a reliable parameter for assessing acetabular morphology ( 41 ).…”

Section: Discussionmentioning

confidence: 99%

Clinical thought-based software for diagnosing developmental dysplasia of the hip on pediatric pelvic radiographs

et al. 2023

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BackgroundThe common methods of radiographic diagnosis of developmental dysplasia of the hip (DDH) include measuring hip parameters and quantifying the degree of hip dislocation. However, clinical thought-based analysis of hip parameters may be a more effective way to achieve expert-like diagnoses of DDH. This study aims to develop a diagnostic strategy-based software for pediatric DDH and validate its clinical feasibility.MethodsIn total, 543 anteroposterior pelvic radiographs were retrospectively collected from January 2017 to December 2021. Two independent clinicians measured four diagnostic indices to compare the diagnoses made by the software and conventional manual method. The diagnostic accuracy was evaluated using the receiver operator characteristic (ROC) curves and confusion matrix, and the consistency of parametric measurements was assessed using Bland-Altman plots.ResultsIn 543 cases (1,086 hips), the area under the curve, accuracy, sensitivity, and specificity of the software for diagnosing DDH were 0.988–0.994, 99.08%–99.72%, 98.07%–100.00%, and 99.59%, respectively. Compared with the expert panel, the Bland-Altman 95% limits of agreement for the acetabular index, as determined by the software, were −2.09°–2.91° (junior orthopedist) and −1.98°–2.72° (intermediate orthopedist). As for the lateral center-edge angle, the 95% limits were −3.68°–5.28° (junior orthopedist) and −2.94°–4.59° (intermediate orthopedist).ConclusionsThe software can provide expert-like analysis of pelvic radiographs and obtain the radiographic diagnosis of pediatric DDH with great consistency and efficiency. Its initial success lays the groundwork for developing a full-intelligent comprehensive diagnostic system of DDH.

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Section: Discussionmentioning

confidence: 99%

Clinical thought-based software for diagnosing developmental dysplasia of the hip on pediatric pelvic radiographs

et al. 2023

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“…Three parameters, that is, AI, acetabular depth ratio A (ADR-A) (the depth ratio measured from the ischium), and acetabular depth ratio B (ADR-B) (the depth ratio measured from the pubic bone), were measured on each pelvic radiograph. [ 19 ] A single orthopedist surgeon with ten years of experience in pediatric orthopedic surgery (ASS) performed the AI and ADR measurements based on a standardized protocol described in the literature [ 1 , 22 ] (Fig. 2 A and B).…”

Section: Methodsmentioning

confidence: 99%

“…[ 5 , 6 ] AI provides an objective parameter of acetabular dysplasia in terms of diagnosis and grading. [ 19 ] On the other hand, ADR has been proposed for the measurement of the width and depth of the acetabulum. [ 16 ] However, intra- and interobserver reliabilities of AI and ADR in evaluating the acetabular morphology have also been criticized.…”

Section: Introductionmentioning

confidence: 99%

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Acetabular index and acetabular depth ratio in newborns and infants aged 6 months or less with the healthy development of hips: A retrospective cross-sectional study

Sarı¹,

Karakuş

Gültekin³

et al. 2023

Medicine

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Radiographic assessment of the hip may render critical in the diagnosis of developmental dysplasia of the hip (DDH) in newborns and infants aged ≤6 months. There is no complete dataset on the acetabular index (AI) and acetabular depth ratio (ADR) values in this age group. The objective of this study was to assess the AI and ADR values in newborns and infants aged ≤6 months with healthy development. A retrospective analysis was performed on pelvic radiographs of newborns and infants (≤6 months) between August 2020 and September 2021. There were 3000 children with pelvic radiographic imaging. Normal sonographic findings and radiographs without any structural deformity of the hip were inclusion criteria. A total of 1132 newborns and infants (2264 hips) were analyzed. Measurements of AI and ADR (ischium and pubic bone as landmarks for acetabular depth ratio A [ADR-A] and acetabular depth ratio B [ADR-B]) were performed. Correlation and intraclass correlation coefficient (ICC) values were calculated. Left-sided AI values were significantly higher than the right-sided AI values, except in infants aged 4 to ≤5 months ( P < .05). ADR-B values differed significantly between male and female newborns and infants both in terms of the side of the hip measured and age ( P < .05). AI values were fairly correlated with age (r = −0.286 for left and r = −0.254 for right) in the negative direction and with ADR-A (r = 0.449 and r = 0.469 for left and right) and ADR-B (r = 0.545 and r = 0.592 for left and right) in the positive direction. Inter-observer ICC was 0.845 to 0.989 (excellent) for AI, 0.534 and 0.904 (moderate to excellent) for ADR-A, and −0.014 and 0.774 (slightly good to good) for ADR-B. Intra-observer ICC was 0.811 to 0.996 (excellent) for AI, 0.575 to 0.98 (moderate to excellent) for ADR-A, and 0.023 to 0.954 (slightly good to excellent) for ADR-B. This study features the first complete data set of AI and ADR measurements, which are essential for pelvic radiographic imaging of hip dysplasia, in newborns and infants aged ≤6 months.

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“…X-ray film can dynamically observe the changes of bone structure during child growth and development, which is the most basic imaging method to evaluate the structural changes of the hip joint, and is important for guiding screening and evaluation of acetabular morphology[ 32 - 34 ]. The following are the main parameters in the evaluation of acetabular morphology by X-ray film[ 35 , 36 ]: Degree of acetabular anteversion, central edge angle (CEA), Acetabular index (AI), sharp angle, angle of iliac wall, and acetabular coverage. The normal acetabulum is usually tilted forward, and it is of clinical importance when the angle is increased by > 7° compared with normal[ 24 ].…”

Section: Evaluation Of Acetabular Morphology By X-ray Filmmentioning

confidence: 99%

Effects of different pelvic osteotomies on acetabular morphology in developmental dysplasia of hip in children

Wang¹,

Wu²,

Kuang³

et al. 2023

World J Orthop

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Developmental dysplasia of hip seriously affects the health of children, and pelvic osteotomy is an important part of surgical treatment. Improving the shape of the acetabulum, preventing or delaying the progression of osteoarthritis is the ultimate goal of pelvic osteotomies. Re-directional osteotomies, reshaping osteotomies and salvage osteotomies are the three most common types of pelvic osteotomy. The influence of different pelvic osteotomy on acetabular morphology is different, and the acetabular morphology after osteotomy is closely related to the prognosis of the patients. But there lacks comparison of acetabular morphology between different pelvic osteotomies, on the basis of retrospective analysis and measurable imaging indicators, this study predicted the acetabular shape after developmental dysplasia of the hip pelvic osteotomy in order to help clinicians make reasonable and correct decisions and improve the planning and performance of pelvic osteotomy.

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Measuring the Acetabular Index: An Accurate and Reliable Alternative Method of Measurement

Cited by 6 publications

References 17 publications

Clinical thought-based software for diagnosing developmental dysplasia of the hip on pediatric pelvic radiographs

Clinical thought-based software for diagnosing developmental dysplasia of the hip on pediatric pelvic radiographs

Acetabular index and acetabular depth ratio in newborns and infants aged 6 months or less with the healthy development of hips: A retrospective cross-sectional study

Effects of different pelvic osteotomies on acetabular morphology in developmental dysplasia of hip in children

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