The pituitary gland enlarges in three dimensions throughout pregnancy. During pregnancy, the volume of the gland shows the highest percentage of increase compared to its length, height, and width. The maximum height of the gland does not exceed 10 mm during pregnancy but it may exceed 10 mm during the 3 days immediately post partum.
Introduction The aim of this study was to determine the differences and consistencies in the morphological and angular interpretations of standard USG images. Therefore, it was aimed to show the correlations of orthopaedic doctors with different periods of experience in hip ultrasound measurements taken with the Graf method. Materials and methods The study included 210 infants randomly selected from those who presented at our hospital for DDH screening. A total of 6 ultrasound images were taken for each hip. These images were evaluated by two paediatric orthopaedic professors, two orthopaedic specialists and two orthopaedic residents. The correlations of these measurements between all the doctors were evaluated statistically. Results In beta angle evaluation, agreement between all the evaluators was at the level of 0.054. No agreement was seen between the two residents or between the two specialists ( p = 0.003, p = 0.998, p = 0.998, respectively). Agreement between the two professors was determined at the level of 0.508 ( p < 0.001). Agreement was determined at the level of 0.066 between the specialists and the residents. No agreement was observed between the specialists and the professors or between the professors and the residents ( p = 0.014, p = 0.098, p = 0.737, respectively). Conclusions It can be concluded that greater emphasis on the beta angle, the cartilage labrum, and more detailed explanations of this subject in the resident training program will achieve standardisation on this subject, and this is in direct proportion to clinical experience. Level of evidence IV
In the Graf method of hip ultrasonography, the diagnosis of the infantile hip with developmental dysplasia of the hip (DDH) is strictly dependent on the bony roof (alpha angle) and the cartilage roof (beta angle) measurements. In this study, we investigated whether the infant hip could be diagnosed with DDH solely by evaluating ultrasound images obtained in the standard plane, without bony roof and cartilage roof measurements, in respect to different professional experience levels. Two hundred ten hip ultrasounds were randomly selected from patients who presented to our hospital for DDH screening. A total of 6 ultrasound images were obtained for each hip. The hip morphology evaluations were made without the bony roof and the cartilage roof measurements by 2 orthopedic surgery residents; 2 orthopedic surgery specialists, trained in the diagnosis and the treatment of the DDH; and 2 pediatric orthopedic surgery professors, highly experienced in the diagnosis and treatment of DDH. After hip morphology evaluations, the bony roof and the cartilage roof measurements were obtained and hip type evaluations were made by the same raters, according to the Graf method of hip ultrasonography. The highest intraobserver agreements between the hip maturity evaluation before and the hip type evaluation after measurements were .676 ( P < .001) and .577 ( P < .001) in professors 2 and 1, respectively, and the lowest agreements were .185 ( P < .01) and .289 ( P < .001) in specialist 1 and resident 2, respectively. The diagnosis of the infant hip as DDH could not be made solely by evaluation of the ultrasound images obtained in the standard plane without the bony roof and the cartilage roof measurements. The bony roof and the cartilage roof measurements were obligatory for the diagnosis of the infant hip as DDH, even in the very experienced pediatric orthopedic surgeons. Level of evidence: 2.
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