Liu Yansong, Ma Yongbo, Liu Zeming, Ding Xuzhuang, Yao Xiaowei, Chang Jiangqi, Li Hao, Wu Tao
Department of Orthopaedic Surgery, The Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, China.
Department of Orthopaedic Surgery, Hebei Provincial Chest Hospital, Shijiazhuang, Hebei, China.
Front Surg. 2025 May 8;12:1512955. doi: 10.3389/fsurg.2025.1512955. eCollection 2025.
Long-term unreduced posterior hip dislocation is a rare and diagnostically challenging condition, with imaging findings often indistinguishable from those of other end-stage hip diseases. It remains a great challenge to determine whether certain imaging characteristics can improve the clinical diagnosis rate of long-term unreduced posterior hip dislocation.
We retrospectively reviewed 24 patients from 2010 to 2022. The diagnostic values of multiple projection angle X-ray and CT 3D reconstruction for long-term unreduced posterior hip dislocation were evaluated.
For aureole sign, 45.83% of patients (sensitivity = 45.83%, specificity = 81.52%, accuracy = 78.67%, Youden's index = 0.274, positive predictive value (PPV) = 17.74%, negative predictive value (NPV) = 94.54%, intraobserver consistency = 0.930, and interobserver consistency = 0.903) were diagnosed correctly. For obturator oblique radiograph of the pelvis, 58.33% of patients (sensitivity = 58.33%, specificity = 82.25%, accuracy = 80.33%, Youden's index = 0.406, PPV = 22.22%, NPV = 95.78%, intraobserver consistency = 0.923, and interobserver consistency = 0.900) were diagnosed correctly. For rhombus sign, 70.83% of patients (sensitivity = 70.83%, specificity = 90.94%, accuracy = 89.33%, Youden's index = 0.618, PPV = 40.48%, NPV = 97.29%, intraobserver consistency = 0.943, and interobserver consistency = 0.900) were diagnosed correctly. For CT 3D reconstruction, axial CT (sensitivity = 70.83%), coronal multiplanar reconstruction (sensitivity = 58.33%), and sagittal multiplanar reconstruction (sensitivity = 54.17%), all had high diagnostic values.
The signs, projection angle X-ray, and CT 3D reconstruction identified in this study are valuable in improving the diagnosis for long-term unreduced posterior hip dislocation.
长期未复位的髋关节后脱位是一种罕见且诊断具有挑战性的疾病，其影像学表现通常与其他终末期髋关节疾病难以区分。确定某些影像学特征是否能提高长期未复位髋关节后脱位的临床诊断率仍然是一个巨大的挑战。
我们回顾性分析了2010年至2022年的24例患者。评估了多投影角度X线和CT三维重建对长期未复位髋关节后脱位的诊断价值。
对于晕圈征，45.83%的患者诊断正确（敏感性=45.83%，特异性=81.52%，准确性=78.67%，约登指数=0.274，阳性预测值（PPV）=17.74%，阴性预测值（NPV）=94.54%，观察者内一致性=0.930，观察者间一致性=0.903）。对于骨盆闭孔斜位片，58.33%的患者诊断正确（敏感性=58.33%，特异性=82.25%，准确性=80.33%，约登指数=0.406，PPV=22.22%，NPV=95.78%，观察者内一致性=0.923，观察者间一致性=0.900）。对于菱形征，70.83%的患者诊断正确（敏感性=70.83%，特异性=90.94%，准确性=89.33%，约登指数=0.618，PPV=40.48%，NPV=97.29%，观察者内一致性=0.943，观察者间一致性=0.900）。对于CT三维重建，轴向CT（敏感性=70.83%）、冠状多平面重建（敏感性=58.33%）和矢状多平面重建（敏感性=54.17%）均具有较高的诊断价值。
本研究中确定的体征、投影角度X线和CT三维重建对提高长期未复位髋关节后脱位的诊断具有重要价值。
