Neurobionplus
Home About Journal AHEAD OF PRINT Current Issue Back Issues Instructions Submission Search Subscribe Blog    
Login 

Users Online: 1053 
Print this page  Email this page Small font sizeDefault font sizeIncrease font size 
ORIGINAL ARTICLE
Year : 2015  |  Volume : 49  |  Issue : 6  |  Page : 610-614

The reliability of ultrasonography in developmental dysplasia of the hip: How reliable is it in different hands?


1 Department of Orthopedic and Traumatology, Fatih Sultan Mehmet Education and Research Hospital, Istanbul, Turkey
2 Department of Orthopedic and Traumatology, Marmara University Education and Research Hospital, Istanbul, Turkey
3 Department of Orthopedic and Traumatology, Biga State Hospital, Çanakkale, Istanbul, Turkey
4 Department of Radiology, Mugla University Education and Research Hospital, Muğla, Istanbul, Turkey
5 Department of Orthopedic and Traumatology, Istanbul Memorial Hospital, Istanbul, Turkey

Correspondence Address:
Mehmet Mufit Orak
Department of Orthopedic and Traumatology, Marmara University Education and Research Hospital, Istanbul
Turkey
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0019-5413.168753

Rights and Permissions

Background: Developmental dysplasia of the hip (DDH) is the most common skeletal dysplasia. Two principal methods used in early diagnosis of DDH are clinical examination and ultrasonographic investigation. Dogruel et al. found a low specificity of clinical examination in patients with DDH. Additionally, Kamath et al. stated that ultrasonography performed by a radiologist in routine clinical practice is more reliable than physical examination performed by the average clinician. In clinical practice, the application and assessment of hip ultrasonography are completed by a single person. This assessment determines the followup of the patient. Thus, hip ultrasonography performed on the same person by different individuals under the same conditions will yield a more accurate assessment of the reliability of ultrasonographic assessment of DDH. Although inter-observer reliability was high in many previous studies of ultrasound image evaluation, reliability rates vary among studies of the application of ultrasonography. Materials and Methods: Inter-examiner reliability of hip ultrasonography was analyzed among four investigators who separately evaluated 100 hips (50 infants). The obtained bone structure angles α, cartilage structure angles β, and distribution of hip types were compared among the investigators. All infants were brought to the hospital for a healthy child followup examination, according to the country's health policy. Babies between 0 and 6 months were included in the study. Babies with any neuromuscular disorders, neural tube defects or any type of genetic anomalies were excluded from the study. The study was explained to the families of all infants and written informed consent was obtained. Results: There was a significant difference in the hip type determined by the investigators with respect to α and β angles (P < 0.01,P< 0.01, P = 0.002). The average alpha measurements of the first orthopedist, second orthopedist, first radiologist, and second radiologist were 67.38 ± 6.24, 65.60 ± 5.84, 65.44 ± 4.59, and 62.59 ± 4.50, respectively. The average beta measurements of the first orthopedist, second orthopedist, first radiologist, and second radiologist were 53.85 ± 8.86, 50.74 ± 7.80, 44.77 ± 6.30, and 44.39 ± 5.81, respectively. Agreement among the results obtained by the clinicians was investigated in dual comparisons. The relative agreement according to the alpha angle ranged from 3.6% to 44.5%, and the relative concordance according to the beta angle ranged from 0.9% to 45.3%. Agreement regarding hip typing was determined to range from 19.1% to 42.6%. Conclusion: Sonographic evaluation of the hip appears to vary depending on the investigator.


[FULL TEXT] [PDF]*
Print this article     Email this article
 Next article
 Previous article
 Table of Contents

 Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
 Citation Manager
 Access Statistics
 Reader Comments
 Email Alert *
 Add to My List *
 * Requires registration (Free)
 

 Article Access Statistics
    Viewed1539    
    Printed18    
    Emailed0    
    PDF Downloaded99    
    Comments [Add]    
    Cited by others 1    

Recommend this journal