Differences of Anteroposterior Pelvic Radiographs Between Supine Position and Standing Position in Patients with Developmental Dysplasia of the Hip

Abstract

ObjectiveTo explore the difference in pelvic tilt and hip joint parameters with developmental dysplasia of the hip (DDH) comparing the anteroposterior (AP) pelvic radiographs taken in supine and standing positions.MethodsA prospective study of DDH patients undergoing Bernese periacetabular osteotomy (PAO) was conducted. AP pelvic radiographs were taken in supine and standing positions before surgery The pelvic tilt and hip joint parameters from the two radiographs were compared. Contrast parameters included the distance between the pubic symphysis to sacrococcygeal distance (PSSC), lateral center‐edge angle (LCEA), Tönnis angle (TA), and angle of sharp (SA).ResultsA total of 110 young DDH patients were enrolled, including 32 men and 78 women, aged 18–49 years. The male PSSC was 45.63 ± 13.69 mm in supine position and 36.91 ± 12.33 mm in standing position (P < 0.05). The female PSSC was 56.76 ± 13.54 mm in supine position and 48.62 ± 15.44 mm in standing position (P < 0.05). In this study, LCEA <20° in AP pelvic radiographs in the supine position was found in 52 men and 135 women. For male patients, in supine position and standing position, LCEA were 5.51° ± 11.88° and 4.45° ± 12.22°, respectively (P < 0.05); TA were 20.20° ± 9.63° and 21.30° ± 9.97°, respectively (P < 0.05), and SA comparison showed no significant differences. For female patients, in supine position and standing position, LCEA were 3.07° ± 12.07° and 1.69° ± 12.11°, respectively (P < 0.05), TA were 22.62° ± 9.31° and 23.82° ± 9.45°, respectively (P < 0.05), and SA were 48.01° ± 4.68° and 48.49° ± 4.74°, respectively (P < 0.05).ConclusionCompared with the supine position, the young DDH patients have pelvic tilt backward and a decrease in hip coverage in the standing position.

A Pilot Investigation of the Social Attention and Communication Surveillance (SACS) Tool for the Early Identification of Autism in Tianjin, China (SACS-C)

“…Over 100,000 babies are born in Tianjin every year, which, based on the estimated prevalence of autism was 27.5 per 10,000 ( 31 ), equates to 1,000–2,000 babies potentially born with autism each year. A thoroughly developed women and child health care system in this city, the Tianjin Women and Children's Health Centre (TWCHC), has made it an ideal test site for the implementation of screening for various child conditions such as congenital heart disease ( 32 ), developmental dysplasia of the hip ( 33 ), and congenital cataract ( 34 ). However, developmental surveillance and screening for autism had not yet been implemented.…”

Arthroscopic Treatment and Outcomes of Borderline Dysplasia With Acetabular Retroversion: A Matched-Control Study From the MASH Study Group

“…The majority of previously published studies have used purely radiographic projections with the COS as the primary indicator of AR, yy and multiple outcome studies investigating AR have used frontal radiographs measuring the LCEA and COS. 4,6,9,23,27 Several studies have established high validity and good to excellent intra-and interrater reliability for the LCEA and COS. 14,15,20,28,42 Moreover, measured values of the LCEA are consistently inflated on CT relative to plain radiography for a wide variety of hip pathologies; patients with dysplasia exhibit a particularly high and clinically significant discrepancy. 1 Several studies support the use of standing frontal radiographs in evaluation of nonarthritic hip pain, particularly for the detection of pincer FAI 12,30,34,40,43 and cranial AR in dysplasia. 37,38 Whereas supine AP pelvic radiographs may overestimate the COS and AR, 45 standing AP pelvic radiographs are most consistent with CT data in the detection of AR, minimize false positives without altering the LCEA, 12,34,40,43 and best approximate physiologic pelvic tilt and femoral head coverage during gait.…”

“…37,38 Whereas supine AP pelvic radiographs may overestimate the COS and AR, 45 standing AP pelvic radiographs are most consistent with CT data in the detection of AR, minimize false positives without altering the LCEA, 12,34,40,43 and best approximate physiologic pelvic tilt and femoral head coverage during gait. 12,30,34,37,38,40,43 The MASH study group recommends the standing AP pelvis view as the standard frontal projection for diagnostic evaluation of the nonarthritic hip.…”

Change of Pelvic Sagittal Tilt after Total Hip Arthroplasty in Patients with Bilateral Crowe Type IV Developmental Dysplasia of the Hip

“…However, the pelvis existing bilateral hip OA and a higher hip dislocation would occur more severe anterior tilt because of soft‐tissue contracture than those with unilateral OA and slight dislocation, and patients with larger anterior tilt preoperatively could occur more obvious changes of PST after the operations 16,18,29 . Therefore, the posterior change of PST after THA in our study could happen earlier and more distinctly compared to the results reported by Suzuki et al ., because bilateral Crowe type IV DDH may be one of the most severe conditions characterized by severe high dislocation, pelvic deformity and lumbar hyper‐lordosis 6,7,9,24,30 …”