Evaluation of the cartilaginous acetabulum by magnetic resonance imaging in developmental dysplasia of the hip

Takeuchi, Ryoko; Kamada, Hiroshi; Mishima, Hajime; Mukai, Naoki; Miyakawa, Shumpei; Ochiai, Naoyuki

doi:10.1097/bpb.0000000000000032

Cited by 21 publications

(22 citation statements)

References 13 publications

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“…They found the cartilaginous HTE to have a better-predicted value than the bony HTE and set a cartilaginous HTE of 13° as a cut-off value between a poor and a good outcome. Only six of 12 hips with RHD were in accordance with those prediction, which constituted a major limitation of this study [37]. Wakabayashi et al introduced the ‘High-Signal Intensity Areas’ on T2-weighted MRI images, as a predictor for acetabular growth and as a decision-making tool for corrective osteotomy in borderline cases of RHD.…”

Section: Discussionmentioning

confidence: 98%

Residual hip dysplasia in children: osseous and cartilaginous acetabular angles to guide further treatment—a pilot study

et al. 2019

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PurposeIn case of residual hip dysplasia (RHD) in children, pelvic radiographs are sometimes insufficient to precisely evaluate the entire coverage of the femoral head, when trying to decide on the need for further reconstructive procedures.MethodsThis study retrospectively compares the bony and the cartilaginous acetabular angle of Hilgenreiner (HTE) of 60 paediatric hips on pelvic MRI separated in two groups. Group 1 included 31 hips with RHD defined by a bony HTE > 20°. Group 2 included 27 hips with a HTE < 20°. They were compared by introducing a new ratio calculated from the square of cartilaginous HTE above the bony HTE on frontal MRI. The normal upper limit for this acetabular angle ratio was extrapolated from the published normal values of cartilaginous HTE and bony HTE in children.ResultsThe acetabular angle ratio was statistically significantly increased in the hips with RHD with a mean value of 7.1 ± 4.7 compared to the hips in the control group presenting a mean value of 2.1 ± 1.9 (p < 0.00001).ConclusionsThis newly introduced ratio seems to be a helpful tool to orientate the further treatment in children presenting borderline RHD.

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Section: Discussionmentioning

confidence: 98%

Residual hip dysplasia in children: osseous and cartilaginous acetabular angles to guide further treatment—a pilot study

et al. 2019

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“…For instance, a significant proliferation, an uneven distribution of stress, a follow-up buffer stress reduction as well as a decrease in friction—all these not only symptomized the severity of the disease but also demonstrated the present stability of the hip and the possible development of the acetabulum in the near future. [17,18] If not properly treated, the reduction would be seriously affected. If information about the AD, BAI, CAI and distribution of acetabular cartilage were received properly, forced reduction that usually leads to abnormal development of the acetabulum and femoral head could be avoided.…”

Section: Discussionmentioning

confidence: 99%

Analysis of acetabulum in children with developmental dysplasia of the hip by MRI scan

Zhou

Lou

et al. 2019

Medicine

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To review the value of acetabular magnetic resonance imaging (MRI) in children with developmental dysplasia of the hip (DDH) of different ages.Eighty-eight medical records of children with unilateral DDH who were diagnosed and treated in our hospital between January 2010 and December 2015 were retrospectively analyzed. The affected hips were put into the case group, and the normal hips were put into the control group. All cases were further divided into 3 age groups: infant (<1 year), 16 cases; young children (1–3 years), 48 cases; and children (3–13 years), 24 cases. The differences of the acetabular depth (AD), the bony acetabular index (BAI), and the cartilaginous acetabular index (CAI) between each group were measured and compared for a linear correlation analysis. At the same time, the distribution of the acetabular cartilage in the anterosuperior, top, and posterosuperior parts (the three parts) from the two groups was measured, respectively.Measurement results from both the case and control groups were as follows: AD was 5.46 ± 2.62 mm and 9.74 ± 2.33 mm; BAI was 33.26 ± 5.49° and 23.50 ± 5.33°; and CAI was 21.04 ± 6.16° and 12.71 ± 4.83°. Differences from the two groups were statistically significant (t = 11.94, 13.78, 9.16, P < .05); BAI and CAI were linearly correlated (r = 0.86, 0.75, P < .05). The AD in infant, young children, and children groups from the case group were 4.26 ± 0.42 mm, 4.79 ± 1.74 mm, and 7.31 ± 2.74 mm, respectively, which was statically significant as well (F = 11.37, P < .05). Under the same grouping criteria, BAI was recorded as 29.04 ± 5.11°, 34.56 ± 4.27°, and 33.12 ± 5.69°; CAI was recorded as 16.62 ± 5.50°, 21.79 ± 6.33°, and 20.91 ± 6.40° separately. There was a linear correlation (r = 0.78, 0.65, P < .05) between BAI and CAI in young children and children groups. The distribution of acetabular cartilage in the above-mentioned three parts from both young children and children groups was statistically significant (P < .05).MRI is a satisfactory imaging modality to children with DDH of different ages for the assessment of AD, BAI, CAI, and acetabular cartilage in multiple locations. It can provide ample imaging reference to clinical evaluation of the acetabulum development in DDH.

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“…The CAI was determined using the angle between the line passing from the most lateral acetabular cartilage and the Hilgenreiner line connecting the 2 triradiate cartilages. The CCE angle was measured as the angle between the line drawn from the center of the femoral head and the line drawn through the longitudinal axis of the body and the most lateral part of the cartilage in the acetabular roof 8 . The OAI angle was measured using the same technique applied on the X-ray.…”

Section: Methodsmentioning

confidence: 99%

Evaluation of cartilage coverage with magnetic resonance imaging in residual dysplasia and its impact on surgical timing

Doğan¹,

Caliskan²,

Duran³

et al. 2019

Acta Orthopaedica et Traumatologica Turcica

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ObjectiveThe aim of this study was to measure the cartilaginous coverage of the acetabulum using magnetic resonance imaging (MRI) and to analyze its effect on the timing and necessity of secondary operations in residual acetabular dysplasia (RAD).MethodsThe MRI results of 33 children (30 girls and 3 boys) aged between 5 and 9 years who were operated on unilaterally via a posteromedial limited approach were compared with the radiographical findings of acetabular dysplasia at follow-up. The acetabular index (AI) and the center-edge (CE) angles were measured. MRI was used to measure the osseous acetabular index (OAI), cartilage acetabular index (CAI), and cartilaginous center-edge angles (CCE). The Children's Hospital's Oakland Hip Evaluation Score (CHOHES) was used for the assessment of clinical and functional results. The Severin scoring system was used to evaluate the radiographic results. The Mann-Whitney U test and Spearman correlation tests were used for statistical analysis.ResultsIn all, 30 (90.9%) girls and 3 (9.1%) boys with an average age of 7.4 years (range: 5–9 years) and a mean follow-up period of 6.1 years (range: 4–8 years) were included. While there was a significant difference between non-dislocated hips and operated hips in 3 measurements (AI, Wiberg CE, and Ogata CE) using X-rays (p < 0.05), no significant difference was found in the MRI measurements (OAI, CAI, and CCE) (p > 0.05). The CAI values were lower than the AI measured on X-ray (p = 0.035). The mean CCE was higher than the mean CE (p = 0.022). The mean CHOHES score was 83.1 (range: 52–100) and the score of 62% patients was above 90. There was no significant difference in terms of CHOHES score according to age at the time of operation (p = 0.43). Three (9.1%) patients were Severin class I, 8 (24.3%) patients were class II, 12 (36.3%) patients were class III and 10 (30.3%) patients were class IV. There was no correlation between preoperative hip dislocation and Severin score (p = 0.056). No significant difference was found between the ambulatory and non-ambulatory groups in terms of Severin classification (p = 0.063).ConclusionCartilaginous acetabulum should be taken into account in RAD measurements. MRI may be a more appropriate option for the evaluation of acetabular cartilaginous coverage in the evaluation of RAD and the decision to perform surgery, though X-rays are currently the most used method. The results revealed no effect on functional or radiological scores as a result of being of walking age.Level of studyLevel III, Diagnostic Study.

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Evaluation of the cartilaginous acetabulum by magnetic resonance imaging in developmental dysplasia of the hip

Cited by 21 publications

References 13 publications

Residual hip dysplasia in children: osseous and cartilaginous acetabular angles to guide further treatment—a pilot study

Residual hip dysplasia in children: osseous and cartilaginous acetabular angles to guide further treatment—a pilot study

Analysis of acetabulum in children with developmental dysplasia of the hip by MRI scan

Evaluation of cartilage coverage with magnetic resonance imaging in residual dysplasia and its impact on surgical timing

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