Department of Orthopaedics and Rheumatology, University Hospital Giessen and Marburg, Marburg, Germany.
BMC Pediatr. 2010 Dec 24;10:98. doi: 10.1186/1471-2431-10-98.
Ultrasonography of the hip has gained wide acceptance as a primary method for diagnosis, screening and treatment monitoring of developmental hip dysplasia in infants. The aim of the study was to examine the degree of concordance of two objective classifications of hip morphology and subjective parameters by three investigators with different levels of experience.
In 207 consecutive newborns (101 boys; 106 girls) the following parameters were assessed: bony roof angle (α-angle) and cartilage roof angle (β-angle) according to Graf's basic standard method, "femoral head coverage" (FHC) as described by Terjesen, shape of the bony roof and position of the cartilaginous roof. Both hips were measured twice by each investigator with a 7.5 MHz linear transducer (SONOLINE G60S® ultrasound system, SIEMENS, Erlangen, Germany).
Mean kappa-coefficients for the subjective parameters shape of the bony roof (0.97) and position of the cartilaginous roof (1.0) demonstrated high intra-observer reproducibility. Best results were achieved for α-angle, followed by β-angle and finally FHC. With respect to limits of agreement, inter-observer reproducibility was calculated less precisely.
Higher measurement differences were evaluated more in objective scorings. Those variations were observed by every investigator irrespective of level of experience.
超声髋关节检查已被广泛接受，成为诊断、筛查和治疗发育性髋关节发育不良的首选方法。本研究旨在检查三位经验水平不同的研究者使用两种客观髋关节形态分类和主观参数的一致性程度。
在 207 例连续新生儿（101 例男孩；106 例女孩）中，评估了以下参数：根据 Graf 的基本标准方法评估骨性顶角度（α 角）和软骨顶角度（β 角）、Terjesen 描述的“股骨头覆盖”（FHC）、骨性顶的形状和软骨顶的位置。每个研究者使用 7.5MHz 线性探头（SONOLINE G60S®超声系统，西门子，德国埃朗根）对双侧髋关节进行两次测量。
骨性顶形状（0.97）和软骨顶位置（1.0）的主观参数的平均 Kappa 系数显示出高度的观察者内可重复性。α 角的测量结果最佳，其次是 β 角，最后是 FHC。就一致性界限而言，观察者间的可重复性计算不够精确。
在客观评分中，评估了更高的测量差异。这些差异是由每个观察者观察到的，无论其经验水平如何。
