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. 2023 Oct 1;105-B(10):1123-1130.
doi: 10.1302/0301-620X.105B10.BJJ-2023-0143.R1.

Paediatric hip ultrasound

Matthew Donnan  1 , Nathan Anderson  1 , Monsurul Hoq  2 , Leo Donnan  1   2
Affiliations

Paediatric hip ultrasound

Matthew Donnan et al. Bone Joint J. .

Abstract

Aims: The aim of this study was to investigate the agreement in interpretation of the quality of the paediatric hip ultrasound examination, the reliability of geometric and morphological assessment, and the relationship between these measurements.

Methods: Four investigators evaluated 60 hip ultrasounds and assessed their quality based the standard plane of Graf et al. They measured geometric parameters, described the morphology of the hip, and assigned the Graf grade of dysplasia. They analyzed one self-selected image and one randomly selected image from the ultrasound series, and repeated the process four weeks later. The intra- and interobserver agreement, and correlations between various parameters were analyzed.

Results: In the assessment of quality, there a was moderate to substantial intraobserver agreement for each element investigated, but interobserver agreement was poor. Morphological features showed weak to moderate agreement across all parameters but improved to significant when responses were reduced. The geometric measurements showed nearly perfect agreement, and the relationship between them and the morphological features showed a dose response across all parameters with moderate to substantial correlations. There were strong correlations between geometric measurements. The Graf classification showed a fair to moderate interobserver agreement, and moderate to substantial intraobserver agreement.

Conclusion: This investigation into the reliability of the interpretation of hip ultrasound scans identified the difficulties in defining what is a high-quality ultrasound. We confirmed that geometric measurements are reliably interpreted and may be useful as a further measurement of quality. Morphological features are generally poorly interpreted, but a simpler binary classification considerably improves agreement. As there is a clear dose response relationship between geometric and morphological measurements, the importance of morphology in the diagnosis of hip dysplasia should be questioned.

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Conflict of interest statement

None declared.

References

    1. Graf R . The diagnosis of congenital hip-joint dislocation by the ultrasonic combound treatment . Arch Orthop Trauma Surg . 1980 ; 97 ( 2 ): 117 – 133 . 10.1007/BF00450934 7458597
    1. Graf R , Mohajer M , Plattner F . Hip sonography update. Quality-management, catastrophes - tips and tricks . Med Ultrason . 2013 ; 15 ( 4 ): 299 – 303 . 10.11152/mu.2013.2066.154.rg2 24286094
    1. Morin C , Zouaoui S , Delvalle-Fayada A , Delforge PM , Leclet H . Ultrasound assessment of the acetabulum in the infant hip . Acta Orthop Belg . 1999 ; 65 ( 3 ): 261 – 265 . 10546348
    1. Terjesen T , Bredland T , Berg V . Ultrasound for hip assessment in the newborn . J Bone Joint Surg Br . 1989 ; 71-B ( 5 ): 767 – 773 . 10.1302/0301-620X.71B5.2684989 2684989
    1. Harcke HT , Pruszczynski B . Hip ultrasound for developmental dysplasia: the 50% rule . Pediatr Radiol . 2017 ; 47 ( 7 ): 817 – 821 . 10.1007/s00247-017-3802-4 28243678