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Radiological findings for hip dysplasia at skeletal maturity. Validation of digital and manual measurement techniques

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Abstract

Objective

To report on intra-observer, inter-observer, and inter-method reliability and agreement for radiological measurements used in the diagnosis of hip dysplasia at skeletal maturity, as obtained by a manual and a digital measurement technique.

Materials and methods

Pelvic radiographs from 95 participants (56 females) in a follow-up hip study of 18- to 19-year-old patients were included. Eleven radiological measurements relevant for hip dysplasia (Sharp’s, Wiberg’s, and Ogata’s angles; acetabular roof angle of Tönnis; articulo-trochanteric distance; acetabular depth-width ratio; femoral head extrusion index; maximum teardrop width; and the joint space width in three different locations) were validated. Three observers measured the radiographs using both a digital measurement program and manually in AgfaWeb1000. Inter-method and inter- and intra-observer agreement were analyzed using the mean differences between the readings/readers, establishing the 95% limits of agreement. We also calculated the minimum detectable change and the intra-class correlation coefficient.

Results

Large variations among different radiological measurements were demonstrated. However, the variation was not related to the use of either the manual or digital measurement technique. For measurements with greater absolute values (Sharp’s angle, femoral head extrusion index, and acetabular depth-width ratio) the inter- and intra-observer and inter-method agreements were better as compared to measurements with lower absolute values (acetabular roof angle, teardrop and joint space width).

Conclusion

The inter- and intra-observer variation differs notably across different radiological measurements relevant for hip dysplasia at skeletal maturity, a fact that should be taken into account in clinical practice. The agreement between the manual and digital methods is good.

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Acknowledgments

We thank radiographer Sigrun Tufta for performing all the high quality radiographs and dr Martin Biermann for all help and advice in the process of converting the pelvic radiographs to DICOM files. The study has received funding from University of Bergen and Arthritis Research UK (grant Ref 18196). Two of the authors (I.Ø.E., L.B.L.) are supported financially by Western Norway Regional Health Authority and one author (T.G.L.) by the Frank Mohn Foundation.

Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Department of Surgical Sciences, University of Bergen, Bergen, Norway

    Ingvild Øvstebø Engesæter, Lene Bjerke Laborie, Trude Gundersen Lehmann, Jonas Fevang, Lars Birger Engesæter & Karen Rosendahl

  2. Department of Orthopaedic Surgery, Haukeland University Hospital, Bergen, Norway

    Ingvild Øvstebø Engesæter, Trude Gundersen Lehmann, Jonas Fevang & Lars Birger Engesæter

  3. Department of Radiology, Haukeland University Hospital, Bergen, Norway

    Ingvild Øvstebø Engesæter, Lene Bjerke Laborie & Karen Rosendahl

  4. Medical Research Council Centre of Epidemiology for Child Health, University College London Institute of Child Health, London, UK

    Francesco Sera

  5. Department of Orthopaedics and Rehabilitation, University of Iowa Hospital & Clinics, Iowa City, IA, USA

    Douglas Pedersen & José Morcuende

  6. Uni Health, Uni Research, Bergen, Norway

    Stein Atle Lie

  7. The Norwegian Arthroplasty Register, Department of Orthopaedic Surgery, Haukeland University Hospital, Møllendalsbakken 11, 5021, Bergen, Norway

    Ingvild Øvstebø Engesæter

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  1. Ingvild Øvstebø Engesæter
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  2. Lene Bjerke Laborie
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  3. Trude Gundersen Lehmann
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  4. Francesco Sera
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  5. Jonas Fevang
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  6. Douglas Pedersen
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  7. José Morcuende
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  8. Stein Atle Lie
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  9. Lars Birger Engesæter
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  10. Karen Rosendahl
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Correspondence to Ingvild Øvstebø Engesæter.

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Engesæter, I.Ø., Laborie, L.B., Lehmann, T.G. et al. Radiological findings for hip dysplasia at skeletal maturity. Validation of digital and manual measurement techniques. Skeletal Radiol 41, 775–785 (2012). https://doi.org/10.1007/s00256-011-1283-3

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  • DOI: https://doi.org/10.1007/s00256-011-1283-3

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