Abstract
BackgroundUltrasonography 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.MethodsIn 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).ResultsMean 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.ConclusionsHigher measurement differences were evaluated more in objective scorings. Those variations were observed by every investigator irrespective of level of experience.
Highlights
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 most widely used method of evaluating ultrasonograms in newborns is the measurement of the bony roof angle (a-angle) and the cartilage roof angle (b-angle) according to Graf [6,7,8]
The aim of our study was to analyze the reproducibility of two objective classifications and descriptive parameters in newborn hip US and the influence of investigators’ level of experience
Summary
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. Discrepancy in measurement may be due to the variability in the US examination itself and in its interpretation Studies demonstrated that both the performance of US and its interpretation influence the results and potential treatment [10,14,15,16]. The aim of our study was to analyze the reproducibility of two objective classifications and descriptive parameters in newborn hip US and the influence of investigators’ level of experience. All three investigators both performed the US and provided the interpretation of their own images in a blinded fashion
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