Reliability of 2D and 3D ultrasound for infant hip dysplasia in the hands of novice users

Mostofi, Emanuel; Chahal, Baljot S.; Zonoobi, Dornoosh; Hareendranathan, Abhilash Rakkunedeth; Roshandeh, Koosha Pourtahmasi; Dulai, Sukhdeep; Jaremko, Jacob L.

doi:10.1007/s00330-018-5699-1

Cited by 30 publications

(19 citation statements)

References 18 publications

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“…With iSlice technology, it is easy to find a more‐or‐less standard plane for measuring the 3D volume data. With 3D ultrasound, the novices produced no false‐positive or false‐negative results, suggesting that 3D ultrasound is more reliable than 2D ultrasound …”

Section: Discussionmentioning

confidence: 93%

“…Developmental dysplasia of the hip refers to a spectrum of hip abnormalities, from dysplasia to subluxation or even dislocation, with an incidence of 0.1% to 2.0% in surviving neonates . Early diagnosis and treatment can effectively restore the hip and improve the prognosis in infants younger than 6 months, but it requires early detection in the suspected hip .…”

Section: Discussionmentioning

confidence: 99%

“…Jaremko et al revealed that 3D ultrasound displayed the full acetabular shape and improved DDH assessment accuracy, as the measured α angles were not affected by the transducer position as they were in 2D scans. The study performed by Mostofi et al revealed that 3D ultrasound had greater reliability and feasibility than 2D ultrasound by comparing the image qualities. Mabee et al found that 3D ultrasound could capture the entire acetabular shape and reproducible standard central plane when considering different observers.…”

Section: Discussionmentioning

confidence: 99%

“…The study by Jaremko et al also revealed that 3D ultrasound could be used to diagnose DDH. A comparison between 2D and 3D ultrasound in hip screening by Mostofi et al showed that 3D ultrasound was more reliable than 2D ultrasound. iSlice (Philips Healthcare, Amsterdam, the Netherlands) is a real‐time 3D analysis technology that can reconstruct the 3D volume and analyze a series of multiplanar images of objects after scanning, similar to computed tomography or magnetic resonance imaging.…”

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confidence: 99%

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Using 3‐dimensional ultrasound islice technology for the diagnosis of developmental dysplasia of the hip

Geng

Zhan

et al. 2019

J of Ultrasound Medicine

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Objectives-This study aimed to investigate the reliability of 3-dimensional (3D) ultrasound in screening for developmental dysplasia of the hip (DDH) by comparing the results with those of 2-dimensional (2D) ultrasound.Methods-One hundred five infants who were younger than 6 months were enrolled in this study. All of the infants underwent 2D and 3D ultrasound scanning for DDH by novices and experts, and the images were graded by a lead expert. The scanning time and image grades were analyzed by Student t tests (P < .05). The consistency of the α angle measurement between the novices and experts was evaluated by the intraclass correlation coefficient (ICC).Results-The 105 infants included 34 boys and 71 girls. On 2D scanning, there was agreement between the experts about the correct diagnosis, whereas in the novice group, 41 infants had misdiagnoses. There were no misdiagnoses with 3D scanning in either group. In the novice group, the mean image grades AE SD were 4.2 AE 1.3 (2D ultrasound) and 8.1 AE 0.7 (3D ultrasound; P < .05). In the expert group, the mean image grades were 7.4 AE 1.0 (2D ultrasound) and 8.2 AE 1.0 (3D ultrasound; P < .05). There was no statistically significant difference between the groups in the grades for 3D ultrasound (P = .83). The scanning time for 3D ultrasound was shorter than that for 2D ultrasound in both groups (P < .05). In the novice group, the ICC of the α angle between the 2D and 3D ultrasound results was 0.34, and in the expert group, it was 0.92. The ICCs were 0.35 and 0.84, respectively when comparing 2D and 3D ultrasound results in the groups.Conclusions-Three-dimensional ultrasound required less time and showed greater inter-rater reliability than 2D ultrasound for detecting DDH.

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Section: Discussionmentioning

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Using 3‐dimensional ultrasound islice technology for the diagnosis of developmental dysplasia of the hip

Geng

Zhan

et al. 2019

J of Ultrasound Medicine

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“…Several recent reports have highlighted the importance of correct ultrasound transducer positioning in relation to the pelvis to achieve reliable results in the ultrasound screening for DDH 8,9,12 . Furthermore, a susceptibility of Graf 's method to relative tilt errors was discussed intensively 9,13 .…”

Section: Discussionmentioning

confidence: 99%

Development of an electronic navigation system for elimination of examiner-dependent factors in the ultrasound screening for developmental dysplasia of the hip in newborns

Kolb

Chiari

Schreiner

et al. 2020

Sci Rep

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To develop an electronic navigation system to increase reliability and comparability in the ultrasound screening of developmental dysplasia of the hip (DDH). The impact of the navigation system on transducer positioning and on sonographic measurements according to Graf was analyzed. Twenty hips in newborns were examined sonographically using a new navigation system capable of detecting the transducer and pelvis position in order to calculate the relative tilt in the frontal, axial, and sagittal-plane. In each newborn an ultrasound image was obtained conventionally according to Graf and a second image using the sonographic navigation system. Relative roll and pitch angles and sonographic measurements were analyzed using paired T-tests and Levene-tests. Relative tilt angles in the conventional group ranged from − 8.9° to 14.3° (frontal-plane) and − 23.8° to 14.2° (axial-plane). In the navigation-assisted group ranges from − 3.0° to 3.5° and − 2.8° to 4.5° were observed. Variances were significantly lower in the navigation-assisted group (p < 0.001 and p = 0.004 respectively). The navigation system allowed for a significant reduction of relative tilt angles between the transducer and the newborn pelvis, thus supporting an optimal transducer positioning. This is a promising approach to improve reproducibility and reliability in the ultrasound screening for DDH.

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Ultrasonographic evaluation of infant hips in the Pavlik harness compared to body‐worn commercial baby carriers

Siddicky

Eckels

Rabenhorst

et al. 2023

Journal Orthopaedic Research

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While many factors contribute to development and subsequent correction of developmental hip dysplasia (DDH) in infants, hip positioning and muscle activity play a significant role. Lower‐limb restrictive extension positions, such as with swaddling, are detrimental for hip development, and some baby gear leads to reduced lower limb muscle activity. Yet how baby gear impacts hip position during wear remains unclear. The purpose of this study was to compare the Graf's alpha angle and femoral head coverage of healthy infants and infants with mild DDH (instability) in the Pavlik harness and baby carriers. We obtained coronal hip ultrasound images of 10 healthy full‐term infants (13.5 ± 3.4 weeks, 5F/5M) and three full‐term mild DDH infants (8.9 ± 4.0 weeks, 2F/1M) in three conditions: Pavlik harness, wide‐base baby carrier, and narrow‐base baby carrier. Repeated measures analysis of variance was used to compare Graf's alpha angles and femoral head coverages across the conditions (p < 0.05), with post hoc pairwise tests (p < 0.0167). The Graf's alpha angle in the narrow‐base carrier was 6.9° lower than the Pavlik harness, while the wide‐base carrier was not different. Femoral head coverage was 10%–12% lower for the narrow‐base carrier. The three mild DDH infants exhibited lower Graf's alpha angles and femoral head coverage in all measurements, with the Graf's alpha angle in the narrow‐base carrier measuring 49.0°. This research demonstrated that wide‐base baby carriers held hips in a position that was not significantly different from the Pavlik harness, meaning that babywearing in a wide‐base carrier may have benefits for healthy hip development.

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Reliability of 2D and 3D ultrasound for infant hip dysplasia in the hands of novice users

Abstract: • Novice/expert inter-rater reliability improved from poor with 2DUS to moderate/high with 3DUS. • Novice operators using 3DUS correctly classified 57/58 (98%) of infant hips. • DDH can be reliably assessed by novice operators using 3DUS.

Cited by 30 publications

References 18 publications

Using 3‐dimensional ultrasound islice technology for the diagnosis of developmental dysplasia of the hip

Using 3‐dimensional ultrasound islice technology for the diagnosis of developmental dysplasia of the hip

Development of an electronic navigation system for elimination of examiner-dependent factors in the ultrasound screening for developmental dysplasia of the hip in newborns

Ultrasonographic evaluation of infant hips in the Pavlik harness compared to body‐worn commercial baby carriers

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