Ultrasound Quantification of Acetabular Rounding in Hip Dysplasia: Reliability and Correlation to Treatment Decisions in a Retrospective Study |
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| Affiliation: | 1. Department of Radiology and Diagnostic Imaging, 2A2.41WC Mackenzie Health Sciences Centre, University of Alberta, Edmonton, Alberta, Canada;2. Department of Biomedical Engineering, 1082 Research Translation Facility, University of Alberta, Edmonton, Alberta, Canada;3. Division of Orthopedic Surgery, Department of Surgery, University of Alberta, Edmonton, Alberta, Canada;1. School of Health and Medical Sciences, Seton Hall University, Wayne, New Jersey, U.S.A.;2. San Diego Sports Medicine and Orthopaedic Center, San Diego, California, U.S.A.;1. American Hip Institute, Westmont, Illinois, U.S.A.;2. Hinsdale Orthopaedics, Westmont, Illinois, U.S.A.;1. Division of Sports Medicine, New York University Langone Orthopedic Hospital, New York, New York, U.S.A.;2. American Sports Medicine Institute, Birmingham, Alabama, U.S.A. |
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| Abstract: | Currently, acetabular rounding is only subjectively assessed on ultrasound for developmental dysplasia of the hip. We tested whether acetabular rounding can be quantified reliably and can distinguish between hips requiring and not requiring treatment. Consecutive infants (n = 90) suspected of having dysplasia of the hip, seen at a pediatric orthopedic clinic, were separated into four diagnostic categories (normal, borderline but resolved, treated by brace, treated surgically). Acetabular rounding was assessed by semi-quantitative grade (0 = nil, 1 = mild, 2 = moderate, 3 = severe) by three observers and by direct measurement of acetabular radius of curvature (AROC) by two observers. Inter-observer reliability of rounding grade was poor (κ = 0.30–0.37). AROC had an inter-observer intra-class correlation coefficient of 0.84 and coefficient of variation of 29%–34%. Mean AROC was significantly higher for hips requiring treatment than for those not requiring treatment (3.3 mm vs. 1.6 mm, p = 0.007). AROC reliably quantifies an observation currently being made subjectively by radiologists and surgeons, and may be useful as a supplementary ultrasound index of dysplasia of the hip in future prospective studies. |
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| Keywords: | Developmental dysplasia of the hip α angle Acetabular rounding Reliability Ultrasound |
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