Imaging Evaluation of Developmental Hip Dysplasia in the Young Adult

Beltrán, Luis; Rosenberg, Zehava Sadka; Mayo, Jason D.; Tuesta, Maria Diaz De; Martin, Olga A.; Neto, Luís Pecci; Bencardino, Jenny T.

doi:10.2214/ajr.12.9360

Cited by 102 publications

(79 citation statements)

References 52 publications

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“…Both computed tomography (CT) and magnetic resonance imaging (MRI), with or without intra-articular contrast medium, have become increasingly common methods to screen for hip pathoanatomy (e.g. 2,15–18 ).…”

Section: Introductionmentioning

confidence: 99%

Computed tomography arthrography with traction in the human hip for three-dimensional reconstruction of cartilage and the acetabular labrum

et al. 2014

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AIM To develop and demonstrate the efficacy of a computed tomography arthrography (CTA) protocol for the hip that enables accurate three-dimensional reconstructions of cartilage and excellent visualization of the acetabular labrum. MATERIALS AND METHODS Ninety-three subjects were imaged (104 scans); 68 subjects with abnormal anatomy, 11 patients after periacetabular osteotomy surgery, and 25 subjects with normal anatomy. Fifteen to 25 ml of contrast agent diluted with lidocaine was injected using a lateral oblique approach. A Hare traction splint applied traction during CT. The association between traction force and intra-articular joint space was assessed qualitatively under fluoroscopy. Cartilage geometry was reconstructed from the CTA images for 30 subjects; the maximum joint space under traction was measured. RESULTS Using the Hare traction splint, the intra-articular space and boundaries of cartilage could be clearly delineated throughout the joint; the acetabular labrum was also visible. Dysplastic hips required less traction (~5 kg) than normal and retroverted hips required (>10 kg) to separate the cartilage. An increase in traction force produced a corresponding widening of the intra-articular joint space. Under traction, the maximum width of the intra-articular joint space during CT ranged from 0.98–6.7 mm (2.46 ± 1.16 mm). CONCLUSIONS When applied to subjects with normal and abnormal hip anatomy, the CTA protocol presented yields clear delineation of the cartilage and the acetabular labrum. Use of a Hare traction splint provides a simple, cost-effective method to widen the intra-articular joint space during CT, and provides flexibility to vary the traction as required.

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Section: Introductionmentioning

confidence: 99%

Computed tomography arthrography with traction in the human hip for three-dimensional reconstruction of cartilage and the acetabular labrum

et al. 2014

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“…Adult acetabular dysplasia appears as a shallow acetabular roof and a small weight-bearing area (1). A shallow acetabular roof may lead to subluxation of the hip, and even a completely dislocated "high-riding" hip.…”

Section: Introductionmentioning

confidence: 99%

“…Several radiological parameters, such as the center-edge angle (CE angle), Tönnis angle, and the femoral-head extrusion index (FHEI), have been utilized to diagnose adult acetabular dysplasia (1,7,8). Tönnis angle has been described with different terms in previous studies (1,(9)(10)(11)(12), such as weight-bearing acetabular index, Lequesne's acetabular index, acetabular roof obliquity and horizontal toit externe angle. It is one of the most common radiological parameters used to evaluate the adult hip.…”

Section: Introductionmentioning

confidence: 99%

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Reliability of a New Radiological Parameter Named the Modified Tönnis Angle for the Evaluation of Acetabular Dysplasia in Adults

Shao

Meng

et al. 2018

Iran J Radiol

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Objectives: To evaluate the reliability of Tönnis angle and modified Tönnis angle on pelvic radiographs in adults. Methods: Conventional anterior-posterior pelvic radiographs of patients were selected from the picture archiving communication system (PACS) in the department of medical radiology of the Second Hospital of Shandong University. Tönnis angle and modified Tönnis angle were measured. All measurements were performed by two experienced observers who worked independently of each other. These measurements were performed again after one month. They were performed digitally using tools of the PACS. Reliability of Tönnis angle and modified Tönnis angle was assessed by intraclass correlation coefficients and Bland and Altman plot.

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“…In total, ~20–50% of adults develop arthritis as a result of subluxation or dysplasia of the hip (6). Adults with acetabular dysplasia usually have a shallow or deformed acetabulum, occasionally with luxation or subluxation of the hip (7). Patients with persistent acetabular dysplasia and subluxation are at high risk of osteoarthritis (OA) (8,9).…”

Section: Introductionmentioning

confidence: 99%

Superiority of the modified Tönnis angle over the Tönnis angle in the radiographic diagnosis of acetabular dysplasia

Wang

2014

Experimental and Therapeutic Medicine

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The aim of this study was to evaluate the limitations of the Tönnis angle as one of the most commonly used parameters in the diagnosis of acetabular dysplasia, and to explore the feasibility of the modified Tönnis angle in the diagnosis of acetabular dysplasia. A total of 224 patients (120 females and 104 males) with 448 hips, aged between 15 and 83 years (median, 45.0 years), were selected for the measurement of the center-edge (CE) and Tönnis angles. To evaluate the relative position of the medial edge of the acetabular sourcil, a new parameter, known as the center-medial-edge (CME) angle, was designed. As an improvement of the Tönnis angle, a new angle preliminarily termed the modified Tönnis angle was created. In addition, the degree of clarity of the medial edge of the acetabular sourcil on radiograph was evaluated, and the hips were divided into the clear-edge and blurred-edge groups. The hips belonging to the blurred-edge group could not be used for Tönnis angle measurements. All measurements were performed digitally using the tool of the picture-archiving communication system. Among the 448 acetabular sourcils, 142 had a blurred medial edge (31.7%). The mean value of the CME angle was 37.94°, with a range of 21.76–63.99°. The 95% prediction interval of the modified Tönnis angle was estimated to be −6.39 to 11.73°. The correlation coefficients were −0.838 between the CE and Tönnis angles, 0.889 between the Tönnis and modified Tönnis angles and −0.905 between the CE and modified Tönnis angles. In conclusion, the modified Tönnis angle can substitute for the Tönnis angle without joint space narrowing and subluxation of the hip, particularly when the Tönnis angle cannot be measured due to a blurred medial edge of the acetabular sourcil on pelvic radiograph.

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Imaging Evaluation of Developmental Hip Dysplasia in the Young Adult

Cited by 102 publications

References 52 publications

Computed tomography arthrography with traction in the human hip for three-dimensional reconstruction of cartilage and the acetabular labrum

Computed tomography arthrography with traction in the human hip for three-dimensional reconstruction of cartilage and the acetabular labrum

Reliability of a New Radiological Parameter Named the Modified Tönnis Angle for the Evaluation of Acetabular Dysplasia in Adults

Superiority of the modified Tönnis angle over the Tönnis angle in the radiographic diagnosis of acetabular dysplasia

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