Troelsen Anders, Rømer Lone, Kring Søren, Elmengaard Brian, Søballe Kjeld
Orthopedic Research Unit, University Hospital of Aarhus, Aarhus, Denmark.
Acta Radiol. 2010 Mar;51(2):187-93. doi: 10.3109/02841850903447086.
Reliable assessment of hip dysplasia and osteoarthritis is crucial in young adults who may benefit from joint-preserving surgery.
To investigate the variability of different methods for diagnostic assessment of hip dysplasia and osteoarthritis.
By each of four observers, two assessments were done by vision and two by angle construction. For both methods, the intra- and interobserver variability of center-edge and acetabular index angle assessment were analyzed. The observers' ability to diagnose hip dysplasia and osteoarthritis were assessed. All measures were compared to those made on computed tomography scan.
Intra- and interobserver variability of angle assessment was less when angles were drawn compared with assessment by vision, and the observers' ability to diagnose hip dysplasia improved when angles were drawn. Assessment of osteoarthritis in general showed poor agreement with findings on computed tomography scan.
We recommend that angles always should be drawn for assessment of hip dysplasia on pelvic radiographs. Given the inherent variability of diagnostic assessment of hip dysplasia, a computed tomography scan could be considered in patients with relevant hip symptoms and a center-edge angle between 20 degrees and 30 degrees . Osteoarthritis should be assessed by measuring the joint space width or by classifying the Tönnis grade as either 0-1 or 2-3.
对于可能从保关节手术中获益的年轻成年人，可靠评估髋关节发育不良和骨关节炎至关重要。
研究髋关节发育不良和骨关节炎诊断评估不同方法的变异性。
由四名观察者分别通过视觉进行两次评估，通过角度构建进行两次评估。对于这两种方法，分析观察者内和观察者间中心边缘角和髋臼指数角评估的变异性。评估观察者诊断髋关节发育不良和骨关节炎的能力。所有测量结果均与计算机断层扫描的结果进行比较。
与视觉评估相比，绘制角度时角度评估的观察者内和观察者间变异性较小，绘制角度时观察者诊断髋关节发育不良的能力有所提高。总体而言，骨关节炎评估与计算机断层扫描结果的一致性较差。
我们建议在骨盆X线片上评估髋关节发育不良时应始终绘制角度。鉴于髋关节发育不良诊断评估存在固有变异性，对于有相关髋关节症状且中心边缘角在20度至30度之间的患者，可考虑进行计算机断层扫描。骨关节炎应通过测量关节间隙宽度或将Tönnis分级分为0 - 1级或2 - 3级来评估。
