Optimum Positioning for Anteroposterior Pelvis Radiography: A Literature Review

Alzyoud, Kholoud; Hogg, Peter; Snaith, Beverly; Flintham, K.; England, Andrew

doi:10.1016/j.jmir.2018.04.025

Cited by 8 publications

(6 citation statements)

References 49 publications

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“…14 Radiographs for the 30 children were performed with 24 standing and 6 supine. While there is some evidence that anterior pelvic tilt increases from supine to standing, 15 we found no relationship between pelvic inclination and radiographic position in our cohort. Therefore, standing and supine radiographs were combined for analysis.…”

Section: Methodscontrasting

confidence: 96%

Reliability and sensitivity of radiographic measures of hip dysplasia in childhood Charcot-Marie-Tooth disease

et al. 2021

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Background: Hip dysplasia is a lack of femoral head coverage and disruption of hip and acetabular alignment and congruency, with severity ranging from mild subluxation in nascent at-risk hips to complete dislocation. Presentation of hip dysplasia in neuromuscular conditions can be sub-clinical or associated with a limp with or without hip pain, abductor and flexor weakness and reduced hip range of motion. Untreated hip dysplasia leads to early onset osteoarthritis requiring hip arthroplasty in early adulthood. Hip dysplasia occurs in 6–20% of children with Charcot-Marie-Tooth disease, however little is known about the reliability and sensitivity of detection on plain film pelvic radiographs. Methods: 14 common measures of hip dysplasia on anteroposterior pelvis radiographs were independently assessed by 2 orthopaedic specialists in 30 ambulant children with Charcot-Marie-Tooth disease. Hip health was also categorised based on clinical impression to assess the sensitivity of radiographic measures to identify hip dysplasia status. Results: 8 measures (acetabular index, head width, lateral centre-edge angle, lateral uncoverage, medial joint width, migration percentage, neck shaft angle, triradiate status) exhibited ‘excellent’ reliability between clinical evaluators. 5 of the 30 patients (17%) were identified as having nascent hip dysplasia. Reliable radiographic measures that significantly distinguished between nascent hip dysplasia and healthy hips were acetabular index, lateral centre edge angle, medial joint width and migration percentage. Conclusions: We have identified a subset of reliable and sensitive radiographic hip measures in children with Charcot-Marie-Tooth disease to prioritise during hip screening to mitigate the deleterious effects of hip dysplasia, pain and disability in adulthood.

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Section: Methodscontrasting

confidence: 96%

Reliability and sensitivity of radiographic measures of hip dysplasia in childhood Charcot-Marie-Tooth disease

et al. 2021

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“…Labels or markers 5. Movement Positioning: X-ray of the pelvis, both hips visible, the obturator foramen should be in its optimal symmetrical position (10).…”

Section: Methodsmentioning

confidence: 99%

The most typical mistakes made during pelvic X-ray in pediatric patients typical mistakes made during pelvic X-ray

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et al. 2022

Journal of Health Sciences and Medicine

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Aim: This study aimed to identify the most common mistakes made during pelvic radiography in pediatric patients and to give advice to physicians and technicians on how to avoid these mistakes. Material and Method:Between 2016 and 2020, 1150 pelvic radiographs (in pediatric patients for any reason) were analyzed by two independent orthopaedic surgeons. Radiographs taken in trauma patients were not included in the study due to the patient's discomfort and agitation. Interobserver and intraobserver reliability for radiographic measurements were determined using intra-class correlation coefficients (ICC) obtained from three replicate sets of measurements on a sample of 1150 radiographs recorded by each observer at least one week apart. Results: The mean age of the patients included in this study was 4.28±3.86 (range: 0-14) years. Of the 1150 patients, 935 (81.30%) were female and 215 (18.69%) were male. When pediatric pelvic radiographs were evaluated, the most common mistake was made during gonad protection. It was found that 71.22% of the patients' gonads could not be protected. While this rate was 82.24% in female patients, this rate was 23.34% in male patients. There was a statistically significant difference when compared by gender (p= 0.015). Giving the malposition was the second most common mistake. Conclusion: The most common errors in pediatric pelvic radiographs are failure to provide gonad protection and malposition of the patient. To minimize these errors, it is necessary to inform both the doctor and the technician.

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“…Preoperative anteroposterior (AP) digital pelvic radiographs were obtained for all patients using a standard protocol (Figure 1 ) with the feet internally rotated at 15 and the X-ray beam centered on the superior margin of the symphysis pubis[ 7 ]. All patient identifiers were removed from radiographs and replaced by unique sequential numbers before being imported into TraumaCad ® (Brainlab, United States) for calibration and templating.…”

Section: Methodsmentioning

confidence: 99%

Anthropometric method for estimating component sizes in total hip arthroplasty

Sahemey¹,

Moores²,

Meacher³

et al. 2021

WJO

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BACKGROUND Preoperative templating is essential in total hip arthroplasty (THA) as it not only helps to facilitate the correct implant type and size but also determines the post-operative biomechanics. Templating is also increasingly important from a medico-legal perspective and recommended in the British Orthopaedic Association Guide to Good Practice. Although templating has become increasingly digitised, there are no simple anthropometric models to predict implant sizes in the absence of digital methods. AIM To assess the accuracy of using an easily obtainable measurement (shoe size) to predict component sizes in THA compared with digital templating. METHODS Digital radiographs from a cohort of 102 patients (40 male, 62 female) who had undergone uncemented or hybrid THA at a single centre were retrospectively templated to desired cup and stem sizes using TraumaCad ® . We compared the templated size to the actual size of the implant and assessed if there was any correlation with the patient’s shoe size. RESULTS Statistically significant positive correlations were observed between: shoe size and templated cup size (ρ = 0.92, P < 0.001); shoe size with implanted cup size (ρ = 0.71, P < 0.001); shoe size and templated stem size (ρ = 0.87, P < 0.001); and shoe size with implanted stem size (ρ = 0.57, P < 0.001). Templated and implanted acetabular cup sizes were positively correlated (ρ = 0.76, P < 0.001) and were exact in 43.1% cases; 80.4% of implanted cup sizes were within 1 size (+/- 2 mm) of the template and 100% within 2 sizes (+/- 4 mm). Positive correlation was also demonstrated between templated and implanted femoral stem sizes (ρ = 0.69, P < 0.001) and were exact in 52.6% cases; 92.6% were within 1 size of the template and 98% within 2 sizes. CONCLUSION This study has shown there to be a significant positive correlation between shoe size and templated size. Anthropometric measurements are easily obtainable and can be used to predict uncemented component sizes in the absence of digital methods.

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Optimum Positioning for Anteroposterior Pelvis Radiography: A Literature Review

Cited by 8 publications

References 49 publications

Reliability and sensitivity of radiographic measures of hip dysplasia in childhood Charcot-Marie-Tooth disease

Reliability and sensitivity of radiographic measures of hip dysplasia in childhood Charcot-Marie-Tooth disease

The most typical mistakes made during pelvic X-ray in pediatric patients typical mistakes made during pelvic X-ray

Anthropometric method for estimating component sizes in total hip arthroplasty

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