Normal Percentile Reference Curves and Correlation of Acetabular Index and Acetabular Depth Ratio in Children

Novais, Eduardo N.; Pan, Zhaoxing; Autruong, Patrick; Meyers, Mariana L.; Chang, Frank M.

doi:10.1097/bpo.0000000000000791

Cited by 69 publications

(114 citation statements)

References 31 publications

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“…In healthy newborns, acetabular measurements often show sex differences with primarily higher AI values in females than in males. During growth, sex differences usually even out leading to a physiological AI decline [18]. In MLII, this decline is missing, which results in a significant sex difference concerning the course of MI and AI values.…”

Section: Discussionmentioning

confidence: 99%

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Hip Morphology in Mucolipidosis Type II

Ammer

Oussoren

Muschol

et al. 2020

JCM

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Mucolipidosis type II (MLII) is a rare lysosomal storage disorder caused by defective trafficking of lysosomal enzymes. Severe skeletal manifestations are a hallmark of the disease including hip dysplasia. This study aims to describe hip morphology and the natural course of hip pathologies in MLII by systematic evaluation of plain radiographs, ultrasounds and magnetic resonance imaging (MRI). An international two-centered study was performed by retrospective chart review. All MLII patients with at least one pelvic radiograph were included. A total of 16 patients were followed over a mean of 3.5 years (range 0.2-10.7 years). Typical age-dependent radiographic signs identified were femoral cloaking (7/16), rickets/hyperparathyroidism-like changes (6/16) and constrictions of the supra-acetabular part of the os ilium (16/16) and the femoral neck (7/16). The course of acetabular and migration indexes (AI, MI) significantly increased in female patients. However, in the overall group, there was no relevant progression of acetabular dysplasia with a mean AI of 23.0 (range 5 • -41 • ) and 23.7 • (range 5 • -40 • ) at the first and last assessments, respectively. Better knowledge on hip morphology in MLII could lead to earlier diagnosis, improved clinical management and enables assessment of effects of upcoming therapies on the skeletal system.

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Section: Discussionmentioning

confidence: 99%

“…The AI is age-, sex-and side-dependent and should become progressively shallower with age. Hip dysplasia was defined by the AI in correlation with reference data by Novais et al [18]. The MI is the ratio of the uncovered femoral head part to the total femoral head width [16].…”

Section: Radiographymentioning

confidence: 99%

Hip Morphology in Mucolipidosis Type II

Ammer

Oussoren

Muschol

et al. 2020

JCM

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“…However, when the data was analyzed by multivariate regression (CART) analysis, the consensus radiographic impression remained vital and was an overall better predictor. Strict AI measurements likely still have a role to play in diagnosis of infantile DDH due their quantifiable nature, but there are other components that make up a surgeon's overall radiographic impression [11] .…”

Section: Discussionmentioning

confidence: 99%

Deciding whether to treat isolated mild dysplasia in infantile DDH: Identifying factors in decision making

Louer

Bomar

Hughes

et al. 2020

Theory Clin Pract Pediatr

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Purpose There is significant variability in brace treatment indications for infantile acetabular dysplasia in the absence of hip dislocation or subluxation. This study's purpose was to evaluate characteristics of treated and untreated patients in our practice. Methods A retrospective chart review was performed of patients aged 0-12 months who were referred to orthopedics with concern for DDH. Demographic and clinical information, as well as provider and radiographic information were recorded for analysis. Five surgeons were independently asked to review de-identified radiographs and note which subjects warranted treatment. A consensus diagnosis of "dysplasia", "no dysplasia", or a lack of consensus were considered as independent variables. Univariate and Classification and Regression Tree (CART) analysis was performed to determine predictors of treatment. Results Mean acetabular inclination (30.6 • vs. 28.2 • ; p = 0.006) and the incidence of abnormal abduction (p = 0.002) were higher for the group that was treated for dysplasia. CART analysis showed that patients with a consensus diagnosis of radiographic dysplasia were more likely to receive treatment than those without consensus, or a consensus of no dysplasia (p <0.001). If consensus was not reached, then abnormal abduction on exam was the next strongest predictor of treatment (p <0.001). Radiographic impression, which was the primary determinant of treatment, exhibited only fair intrarater and interrater reliability. Conclusions We studied factors that led to the diagnosis and treatment of DDH in an infant population. We observed that radiographic impression and abnormal abduction on exam were the only reliable factors predictive of treatment among our practice.

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“…En 2016 Novais EN, et al (12) , estudiaron 1734 pacientes pediátricos sin patología de caderas a fin de determinar los valores normales de IA y de su correcta progresión en el tiempo obteniendo valores referenciales según edad, sexo y lateralidad. (12)…”

Section: Ceja Acetabularunclassified

“…Pacientes con caderas estables al examen físico, una radiografía anteroposterior de pelvis correctamente tomada y simétrica y un índice acetabular elevado según los valores propuestos por Novais EN, et al (12) , fueron incluidos en el estudio. (12) , (Tabla 1): la media del índice acetabular fue 28,04° ± 1,73°, 66% y 60% de los pacientes presentaron índices acetabulares derechos e izquierdos superiores a lo normal respectivamente y 23% presentaron índices superiores en las dos caderas.…”

Section: Artículo Original Estudio Retrospectivounclassified

Diferentes índices radiográficos versus Índice Acetabular en la decisión de colocación de Arnés de Pavlik en pacientes con diagnóstico de Displasia de Cadera

Tirado¹,

Cifuentes²

2019

RMV

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There are different x-ray indices and classifications for the diagnosis of Hip Developmental Dysplasia, this study compared the usefulness of different x-ray parameters in patients with high acetabular indices to determine whether or not would benefit from orthopedic treatment. Patients and Methods: Retrospective cohort study. Patients aged 3 to 7 months, attended in the external consultation of Traumatology and Pediatric Orthopedics of the Hospital Vozandes Quito in the period January to December 2017 were included in the study. Signs of hip instability to physical examination, radiographic measurements: acetabular index, percentage of femoral head migration, Smith index, Tonnis classification by quadrants, formation of the radiographic acetabular eyebrow were obtained from the medical record of each patient. Results: 104 patients were evaluated, the median age at the time of diagnosis was 4.63 months, 52% were male and the mean acetabular index was 37.9 degrees. Patients were subdivided into 2 groups according to the orthopedic treatment instituted: with Pavlik harness (38.5%) and without a harness (61.5%). When comparing patients without and with harness we got an OR of 1.07 and a value of p-0.69. Patients with a Grade I Tonnis scale had a 96% chance of developing a normal hip relative to Tonnis Grade II (60%), with an OR of 21.3 and p-0.69. Conclusions: There is a group of patients with a high acetabular index and hips stable to the physical examination who would not benefit from orthopedic treatment, within all the parameters evaluated we observe that the normal radiographic acetabular eyebrow and the Tonnis scale grade I were predictor parameters of a good response at 2 months.

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Normal Percentile Reference Curves and Correlation of Acetabular Index and Acetabular Depth Ratio in Children

Abstract: Level IV-case series.

Cited by 69 publications

References 31 publications

Hip Morphology in Mucolipidosis Type II

Hip Morphology in Mucolipidosis Type II

Deciding whether to treat isolated mild dysplasia in infantile DDH: Identifying factors in decision making

Diferentes índices radiográficos versus Índice Acetabular en la decisión de colocación de Arnés de Pavlik en pacientes con diagnóstico de Displasia de Cadera

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