ArticleJournal of orthopaedic surgery and research2020
How to judge pelvic malposition when assessing acetabular index in children? Three simple parameters can determine acceptability.
Article in Journal of orthopaedic surgery and research, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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11 citing papers in PubMed, 18 citations in OpenAlex.
- Comparison of Transfer Learning Models in Pelvic Tilt and Rotation Measurement in Pediatric Anteroposterior Pelvic Radiographs.Journal of digital imaging · 2022Trial
- Equivalence of Anteroposterior and Frog-Leg Lateral Radiographs in Measuring Acetabular Index in Children.Research square · 2026Article
- Assessing deep learning accuracy in the measurement of radiographic parameters in pediatric hip X-rays.BMC medical imaging · 2025Article
- A dataset for quality evaluation of pelvic X-ray and diagnosis of developmental dysplasia of the hip.Scientific data · 2025Article
- The role of pelvic coronal parameters in determining sagittal balance: a prospective radiographic analysis of pelvic spinopelvic alignment in Chinese asymptomatic Han adolescents.Frontiers in pediatrics · 2025Article
- Risk factors for templating mismatch of uncemented stems in bipolar hemiarthroplasty for femoral neck fracture.Scientific reports · 2023Article
- A novel approach for screening standard anteroposterior pelvic radiographs in children.European journal of pediatrics · 2023Article
- MRI May Be More Valuable than Pelvic Radiographs in the Assessment of Paediatric Borderline Acetabular Dysplasia.Children (Basel, Switzerland) · 2023Article
- Effects of pelvic obliquity and limb position on radiographic leg length discrepancy measurement: a Sawbones model.Journal of experimental orthopaedics · 2022Article
- An Upgrade of the International Hip Dysplasia Institute Classification for Developmental Dysplasia of the Hip.Clinics in orthopedic surgery · 2022Article
- What is the association between MRI and conventional radiography in measuring femoral head migration?Acta orthopaedica · 2021Article
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Authors and funding
6 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe acetabular index (AI) is the most commonly used parameter for diagnosing hip dysplasia. Pelvic malposition can result in misinterpretation of AI measurement especially in younger children. We aimed to investigate the correlation between pelvic orientation and acetabular index (AI) by using digital reconstructed radiographs (DRRs) and identify reliable parameters predictive of pelvic orientation on plain radiographs.
methodsWe retrospectively identified 33 children (52 hips) who received dual source CT examinations. Virtual pelvic models were reconstructed after scanning. After orientating in the standard neutral position, the models were rotated and tilted around corresponding axes. DRRs were generated at every 3° during the process. The acetabular index, the horizontal diameter (Dh) and vertical diameter (Dv) of bilateral obturator foramina, the vertical distance (h) between upper border of pubic symphysis, and Hilgenreiner's line were measured on each DRR by two independent observers. Rotation index (Rr = right Dh/left Dh), tilt index (Rt = h/Dv), intra-observer error, and inter-observer error of AI were calculated.
resultsFor tilt and rotation up to 12.0°, AI increased with anterior tilt and decreased with posterior tilt. And for rotation, it increased on the side toward which the pelvis rotated and decreased on the opposite side. AI varied dramatically if angulation exceeded 6.0°. Malposition below this limit demonstrated the intra- and inter-observer errors were ± 2.0° and ± 3.0° respectively and caused no significant effect on AI measurement.
conclusionsFor children up to age 6 years, an acceptable pelvic plain radiograph can be determined when Rt is approximately between 0.9 and 1.4 and Rr between 0.7 and 1.5. For the first time, we have identified parameters derived from a group of subjects which can predict this degree of malposition. The parameters obturator diameters (Dh), obturator height (Dv), and distance (h) between symphysis and Hilgengreiner's line can be feasibly measured on X-ray and employed in clinical practice to assess the acceptability of the pediatric pelvic radiograph prior to measurement of the AI.
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