The Ambiguity of Names and Landmarks in Radiographs of the Pediatric Pelvis: Variations and a Historical Perspective

Overview

Journal J Am Acad Orthop Surg Glob Res Rev

Specialty Orthopedics

Date 2023 Sep 21

PMID 37734040

Authors

Henrik Hedelin

Per Larnert

Tero Laine

Mikael Sansone

Hanna Hebelka

Affiliations

Soon will be listed here.

Abstract

For over a century, the plain radiograph has been used to measure and predict the development of pediatric hip conditions. Classic measurements, such as the acetabular index, the center-edge angle, and the migration percentage, have stood the test of time and remain the default tools for any pediatric orthopaedic surgeons. However, in contemporary research, the terminology regarding these measurements has become markedly inconsistent. A substantial number of synonyms, acronyms, and similar, but not identical, terms are used to label measurements. This is perhaps unsurprising, considering decades of use and numerous suggested modifications. The results of treatment cannot be reliably compared if the measured parameters are not identical, and scientific analysis of disease requires consistent terminology. In this review, we aim both to provide historical definitions and identification of radiographic landmarks commonly used in three parameters of interest on pediatric AP radiographs and to examine the variability of landmarks and definitions in contemporary research.

References

Novais E, Bixby S, Rennick J, Carry P, Kim Y, Millis M . Hip dysplasia is more severe in Charcot-Marie-Tooth disease than in developmental dysplasia of the hip. Clin Orthop Relat Res. 2013; 472(2):665-73. PMC: 3890158. DOI: 10.1007/s11999-013-3127-z. View

Baki M, Baki D, Aydin H, Kerimoglu S, Baki C . Radiological evaluation of combined valgus extension osteotomy and tectoplasty for the treatment of Herring group C Perthes patients. Eklem Hastalik Cerrahisi. 2011; 22(2):64-8. View

Tonnis D . [Indications and time planning for operative interventions in hip dysplasia in child and adulthood]. Z Orthop Ihre Grenzgeb. 1985; 123(4):458-61. View

Hosalkar H, Munhoz da Cunha A, Baldwin K, Ziebarth K, Wenger D . Triple innominate osteotomy for Legg-Calvé-Perthes disease in children: does the lateral coverage change with time?. Clin Orthop Relat Res. 2011; 470(9):2402-10. PMC: 3830082. DOI: 10.1007/s11999-011-2189-z. View

Ogata S, Moriya H, Tsuchiya K, Akita T, Kamegaya M, Someya M . Acetabular cover in congenital dislocation of the hip. J Bone Joint Surg Br. 1990; 72(2):190-6. DOI: 10.1302/0301-620X.72B2.2312554. View

Lequesne M, de SEZE . [False profile of the pelvis. A new radiographic incidence for the study of the hip. Its use in dysplasias and different coxopathies]. Rev Rhum Mal Osteoartic. 1961; 28:643-52. View

Rosello O, Solla F, Oborocianu I, Chau E, ElHayek T, Clement J . Advanced containment methods for Legg-Calvé-Perthes disease: triple pelvic osteotomy versus Chiari osteotomy. Hip Int. 2017; 28(3):297-301. DOI: 10.5301/hipint.5000569. View

Broughton N, Brougham D, Cole W, MENELAUS M . Reliability of radiological measurements in the assessment of the child's hip. J Bone Joint Surg Br. 1989; 71(1):6-8. DOI: 10.1302/0301-620X.71B1.2915007. View

Heimkes B, Schmidutz F, Rosner J, Frimberger V, Weber P . [Modified Salter innominate osteotomy in adults]. Oper Orthop Traumatol. 2018; 30(6):457-468. DOI: 10.1007/s00064-018-0560-x. View

10.

Shin C, Yang E, Lim C, Yoo W, Choi I, Cho T . Which Acetabular Landmarks are the Most Useful for Measuring the Acetabular Index and Center-edge Angle in Developmental Dysplasia of the Hip? A Comparison of Two Methods. Clin Orthop Relat Res. 2020; 478(9):2120-2131. PMC: 7431232. DOI: 10.1097/CORR.0000000000001289. View

11.

Heidt C, Hollander K, Wawrzuta J, Molesworth C, Willoughby K, Thomason P . The radiological assessment of pelvic obliquity in cerebral palsy and the impact on hip development. Bone Joint J. 2015; 97-B(10):1435-40. DOI: 10.1302/0301-620X.97B10.35390. View

12.

Werner C, Ramseier L, Ruckstuhl T, Stromberg J, Copeland C, Turen C . Normal values of Wiberg's lateral center-edge angle and Lequesne's acetabular index--a coxometric update. Skeletal Radiol. 2012; 41(10):1273-8. DOI: 10.1007/s00256-012-1420-7. View

13.

Sonekatsu M, Sonohata M, Inoue T, Honke H, Kitajima M, Kawano S . Investigation of the priority among the roentgenogram measurements in acetabular dysplasia. J Orthop Surg (Hong Kong). 2020; 28(3):2309499020950575. DOI: 10.1177/2309499020950575. View

14.

Agus H, Bicimoglu A, Omeroglu H, Tumer Y . How should the acetabular angle of Sharp be measured on a pelvic radiograph?. J Pediatr Orthop. 2002; 22(2):228-31. View

15.

Faraj S, Atherton W, Stott N . Inter- and intra-measurer error in the measurement of Reimers' hip migration percentage. J Bone Joint Surg Br. 2004; 86(3):434-7. DOI: 10.1302/0301-620x.86b3.14094. View

16.

Clohisy J, Carlisle J, Beaule P, Kim Y, Trousdale R, Sierra R . A systematic approach to the plain radiographic evaluation of the young adult hip. J Bone Joint Surg Am. 2008; 90 Suppl 4:47-66. PMC: 2682767. DOI: 10.2106/JBJS.H.00756. View

17.

Herickhoff P, OBrien M, Dolan L, Morcuende J, Peterson J, Weinstein S . The gothic arch: a reliable measurement for developmental dysplasia of the hip. Iowa Orthop J. 2013; 33:1-6. PMC: 3748863. View

18.

Mast N, Impellizzeri F, Keller S, Leunig M . Reliability and agreement of measures used in radiographic evaluation of the adult hip. Clin Orthop Relat Res. 2010; 469(1):188-99. PMC: 3008883. DOI: 10.1007/s11999-010-1447-9. View

19.

Li Y, Guo Y, Li M, Zhou Q, Liu Y, Chen W . Acetabular index is the best predictor of late residual acetabular dysplasia after closed reduction in developmental dysplasia of the hip. Int Orthop. 2017; 42(3):631-640. DOI: 10.1007/s00264-017-3726-5. View

20.

Tonnis D . Surgical treatment of congenital dislocation of the hip. Clin Orthop Relat Res. 1990; (258):33-40. View