Accuracy of Clinical and Imaging Tests for the Diagnosis of Hip Dysplasia and Instability: A Systematic Review

Reiman, Michael P.; Décary, Simon; Mathew, Benoy; Reiman, Carly K

doi:10.2519/jospt.2019.8476

Cited by 12 publications

(14 citation statements)

References 41 publications

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“…On the AP pelvic radiograph, the W-LCEA is defined as the angle between a vertical line drawn upward from the most central point of the femoral head and a line from the central point tangential to the lateral margin of the weight-bearing area of the acetabulum (rather than the lateral rim of the acetabulum) [ 12 , 13 ]. The central point of the femoral head was found by drawing a best-fitted circle around the femoral head based on the SSM point sets.…”

Section: Methodsmentioning

confidence: 99%

“…Clinical findings include pain provoked with the hip instability tests (hyperextension-external rotation (HEER), Abduction-hyperextension-external rotation (AB-HEER) and the PRONE instability test), abductor fatigue with a positive Trendelenburg sign and increased range of motion of the hip [ 5 , 8–11 ]. In order to make the diagnosis of DDH complete, anteroposterior (AP) pelvic radiographs are usually obtained [ 12 , 13 ].…”

Section: Introductionmentioning

confidence: 99%

“…However, the W-LCEA only quantifies lateral acetabular coverage and might therefore lead to an underestimation of DDH prevalence, potentially resulting in delayed diagnosis [ 7 , 17 ]. An additional lateral view, the false-profile (FP) view, can be used to determine the anterior acetabular coverage of the femoral head, which can be quantified by the Wiberg-anterior center-edge angle (W-ACEA) [ 8 , 12 , 13 , 18 , 19 ]. As DDH is a condition that can be both present laterally and anteriorly, an additional value of the FP view radiograph is to be expected.…”

Section: Introductionmentioning

confidence: 99%

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Adding false-profile radiographs improves detection of developmental dysplasia of the hip, data from the CHECK cohort

Herfkens

Buuren

Riedstra

et al. 2022

Journal of Hip Preservation Surgery

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The aim of this study was to determine the additional value of the false-profile (FP) view radiograph in the diagnosis of developmental dysplasia of the hip (DDH), as compared with an anteroposterior (AP) pelvic radiograph only, and evaluate the correlation between the Wiberg-lateral center edge angle (W-LCEA) and Wiberg-anterior center edge angle (W-ACEA). We used baseline data from a nationwide prospective cohort study (Cohort Hip and Cohort Knee). DDH was quantified on AP pelvic and FP hip radiographs using semi-automatic measurements of the W-LCEA and W-ACEA. A threshold of <20° was used to determine DDH for both the W-LCEA and the W-ACEA. The proportion of DDH only present on the FP view determined the FP view additional value. The correlation between the W-LCEA and W-ACEA was determined. In total 720 participants (1391 hips) were included. DDH was present in 74 hips (5.3%), of which 32 were only present on the FP view radiograph (43.2%). The Pearson correlation coefficient between W-LCEA and W-ACEA of all included hips was 0.547 (95% confidence interval: 0.503–0.591) and 0.441 (95% confidence interval: 0.231–0.652) in hips with DDH. A mean difference of 9.4° (SD 8.09) was present between the W-LCEA and the W-ACEA in the hips with DDH. There is a strong additional value of the FP radiograph in the diagnosis of DDH. Over 4 out of 10 (43.2%) individuals’ DDH will be missed when only using the AP radiograph. In hips with DDH a moderate correlation between W-LCEA and W-ACEA was calculated indicating that joints with normal acetabular coverage on the AP view can still be undercovered on the FP view.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Adding false-profile radiographs improves detection of developmental dysplasia of the hip, data from the CHECK cohort

Herfkens

Buuren

Riedstra

et al. 2022

Journal of Hip Preservation Surgery

View full text Add to dashboard Cite

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“…Preoperative radiographs were obtained for each hip utilizing a standing anterior-posterior view of the pelvis, false profile view, and 45° Dunn view. The following angles were measured for each radiograph: LCEA, 56 Tönnis angle, 54 neck shaft angle, ACEA, 29 alpha angle, 47 femoral head extrusion index, 41 and ADWR. 22 Radiographic analysis was performed utilizing a picture archiving and communication system.…”

Section: Methodsmentioning

confidence: 99%

“…They include Heyman and Herndon’s 22 acetabular depth-to-width ratio (ADWR), femoral head extrusion index, 41 Eijer head-neck offset, 38 neck shaft angle, anterior center edge angle (ACEA) of Lequesne and de Seze, 29 lateral center edge angle (LCEA) of Wiberg, 56 Tönnis angle, 54 acetabular inclination angle, 42 disruption of the Shenton line, 47 and several others. 47 Although the degree of hip dysplasia is most commonly defined using the LCEA of Wiberg, this single unidimensional radiographic measurement is likely inadequate to effectively classify this complex 3D deformity. 6,23,32 As with every procedure, favorable outcomes occur when choosing proper surgical candidates.…”

mentioning

confidence: 99%

A Multicenter Study of Radiographic Measures Predicting Failure of Arthroscopy in Borderline Hip Dysplasia: Beware of the Tönnis Angle

et al. 2020

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Background: Hip arthroscopy has been previously demonstrated to be an effective treatment for adult mild hip dysplasia. There are many radiographic parameters used to classify hip dysplasia, but to date few studies have demonstrated which parameters are of most importance for predicting surgical outcomes. Purpose: To identify preoperative radiographic parameters that are associated with poor outcomes in the arthroscopic treatment of adult mild hip dysplasia. Study Design: Case-control study; Level of evidence, 3. Methods: Radiographic analysis was performed in patients with mild hip dysplasia who underwent arthroscopic surgery between 2009 and 2015. Preoperative radiographic measurements included lateral center edge angle, Tönnis angle, neck shaft angle, anterior center edge angle, alpha angle, femoral head extrusion index, and acetabular depth-to-width ratio. Failure was defined as failure to achieve the minimal clinically important difference (MCID) utilizing the modified Harris Hip Score or as the need for secondary operation. The equal variance t test was used to analyze radiographic parameters. Statistical significance was determined using a P value of .05. Results: A total of 373 hips underwent analysis with an average follow-up of 41 months (range, 24-102 months). Of these, 46 hips (12%) required secondary operation, and 95 (25%) failed to meet the MCID. The overall failure rate was 32.4%. There was no single measurement or combination thereof associated with failure to reach the MCID. Higher preoperative Tönnis angles were associated with secondary operation, with a mean of 6.7° (95% CI, 5.3°-8.1°) in the secondary operation group versus 4.8° (95% CI, 4.4°-5.3°) in the nonsecondary operation group ( P = .006). The odds ratio was 1.12 (95% CI, 1.0-1.2; P = .05) per degree increase in Tönnis angle for secondary operation. In patients with a Tönnis angle >10°, 84% required secondary operation. Conclusion: Higher Tönnis angles portend a higher risk for revision surgery. The probability of secondary operation was increased by a magnitude of 1.12 with each degree increase in the Tönnis angle. In patients with a Tönnis angle >10°, 84% required a secondary operation.

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A New Clinical Examination Algorithm to Prescribe Conservative Treatment in People with Hip-Related Pain

González-de-la-Flor

2024

Pain Ther

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Hip-related pain is a common issue in active adults affecting their quality of life, mobility, and overall function, and it can lead to persistent disability. However, diagnosing hip-related pain is challenging due to the many potential sources and causes, including intra-articular and extra-articular pathology, and referred pain from other areas (lumbar or groin related pain). To address this, there is a need for a clinical algorithm based on the best available evidence and expert consensus. This algorithm could guide healthcare professionals in assessing and managing patients with hip-related pain, during the diagnosis, test selection, intervention, monitoring, and promoting collaboration among various healthcare providers. This clinical algorithm for hip-related pain is a comprehensive, flexible, adaptable to different settings, and regularly updated to incorporate new research findings. This literature review aims to establish a clinical algorithm specifically for prescribing exercise treatment to patients with hip-related pain, addressing their individual needs and enhancing their overall care.

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Accuracy of Clinical and Imaging Tests for the Diagnosis of Hip Dysplasia and Instability: A Systematic Review

Cited by 12 publications

References 41 publications

Adding false-profile radiographs improves detection of developmental dysplasia of the hip, data from the CHECK cohort

Adding false-profile radiographs improves detection of developmental dysplasia of the hip, data from the CHECK cohort

A Multicenter Study of Radiographic Measures Predicting Failure of Arthroscopy in Borderline Hip Dysplasia: Beware of the Tönnis Angle

A New Clinical Examination Algorithm to Prescribe Conservative Treatment in People with Hip-Related Pain

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