Department of Orthopedic Surgery, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA.
J Bone Joint Surg Am. 2011 May;93 Suppl 2:35-9. doi: 10.2106/JBJS.J.01717.
Undetected developmental dysplasia of the hip can progress to hip instability, which can lead to the development of early osteoarthritis. The purpose of the present study was to determine the reliability and accuracy of the Shenton line in the diagnosis of acetabular dysplasia in the skeletally mature patient.
Supine anteroposterior pelvic radiographs were obtained for a total of 128 hips in patients with a diagnosis of developmental dysplasia of the hip prior to pelvic osteotomy (sixty-four hips, including thirty-two left and thirty-two right hips) and normal patients (sixty-four hips, including thirty-two left and thirty-two right hips). Six orthopaedic surgeons determined if the Shenton line was broken or intact to determine interobserver reliability. Four observers reviewed the randomized radiographs again after four weeks to determine intraobserver reliability.
The mean intraclass kappa value was 0.90 (range, 0.79 to 0.97), indicating excellent agreement between each reviewer's primary and secondary reviews. The kappa estimate for interobserver reliability among all six reviewers was 0.80 (95% confidence interval, 0.75 to 0.84), indicating an excellent agreement. The determination of a normal or abnormal Shenton line had a mean sensitivity of 83.3% (range, 60.9% to 93.8%) and specificity of 98.4% (range, 92.2% to 100%).
The Shenton line is a reliable and accurate radiographic marker to detect superior femoral head subluxation indicative of acetabular dysplasia.
未被发现的髋关节发育不良可能会进展为髋关节不稳定，进而导致早期骨关节炎的发生。本研究旨在确定 Shenton 线在诊断骨骼成熟患者髋臼发育不良中的可靠性和准确性。
共对 128 髋发育性髋关节发育不良患者（64 髋，包括 32 例左侧和 32 例右侧髋）和正常患者（64 髋，包括 32 例左侧和 32 例右侧髋）术前仰卧前后骨盆 X 线进行分析。六位骨科医生判断 Shenton 线是否中断以确定观察者间的可靠性。四位观察者在四周后再次随机查看 X 线片以确定观察者内的可靠性。
平均组内 κ 值为 0.90（范围，0.79 至 0.97），表明每位观察者的初次和二次评估之间具有极好的一致性。六位医生中所有医生的观察者间 κ 值估计为 0.80（95%置信区间，0.75 至 0.84），表明极好的一致性。正常或异常 Shenton 线的确定具有 83.3%（范围，60.9%至 93.8%）的平均敏感性和 98.4%（范围，92.2%至 100%）的特异性。
Shenton 线是一种可靠且准确的放射学标志物，可用于检测提示髋臼发育不良的股骨头上方半脱位。
