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Erschienen in: Skeletal Radiology 2/2009

01.02.2009 | Review Article

A new tilt on pelvic radiographs: a pilot study

verfasst von: P. J. Richards, J. M. Pattison, J. Belcher, R. W. DeCann, Suzanne Anderson, C. Wynn-Jones

Erschienen in: Skeletal Radiology | Ausgabe 2/2009

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Abstract

Aim

The aim of this study was to evaluate pelvic tilt on commonly performed measurements on radiography in primary protrusio acetabuli and developmental dysplasia of the hip.

Materials and methods

A dry assembled pelvis and spine skeleton was positioned in an isocentric skull unit and films exposed with increasing degrees of angulation of pelvic tilt. The films were then read by two independent readers for seven different measurements used to evaluate the hips and acetabular: acetabular line to ilioischial line, teardrop appearance, intercristal/intertuberous ratio, co-ordinates of femoral head, centre edge angle, acetabular depth/width ratio and acetabular angle.

Results

There was so much variation in the protrusio results that no formal recommendation of any standard radiographic test can be given. Only the inter tuberous distance is not effected by pelvic tilt. The acetabular angles for developmental dysplasia of the hip showed the most potential with pelvic tilt below 15°.

Conclusion

As pelvic tilt increases, measurements used in protusio become unreliable, and computed tomography/magnetic resonance imaging are probably going to be more accurate as one can directly visualise pelvic intrusion. We recommend a lateral view to assess the degree of pelvic tilt in patients with protrusion to ensure these measurements are valid.
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Literatur
1.
Zurück zum Zitat Resnick D, Niwayama G. Diagnosis of bone and joint disorders. 2nd ed. Philadelphia: Saunders; 1988. p. 3582–3583. Resnick D, Niwayama G. Diagnosis of bone and joint disorders. 2nd ed. Philadelphia: Saunders; 1988. p. 3582–3583.
2.
Zurück zum Zitat Shore A, Macauley D, Ansell BM. Idiopathic protrusio acetabuli in juveniles. Rheumatol Rehabil 1981; 20: 1–10.PubMedCrossRef Shore A, Macauley D, Ansell BM. Idiopathic protrusio acetabuli in juveniles. Rheumatol Rehabil 1981; 20: 1–10.PubMedCrossRef
3.
Zurück zum Zitat D’Arcy K, Ansell BM, Bywaters EGL. A family with primary protrusio acetabuli. Ann Rheum Dis 1978; 37: 53–57.PubMedCrossRef D’Arcy K, Ansell BM, Bywaters EGL. A family with primary protrusio acetabuli. Ann Rheum Dis 1978; 37: 53–57.PubMedCrossRef
4.
Zurück zum Zitat Friedenberg ZB. Protrusio acetabuli in childhood. J Bone Jt Surg 1963; 45A (2): 373–378. Friedenberg ZB. Protrusio acetabuli in childhood. J Bone Jt Surg 1963; 45A (2): 373–378.
6.
Zurück zum Zitat Gilmour J. Adolescent deformities of the acetabulum—an investigation into the nature of protrusio. Br J Surg 1938; 26: 670–699.CrossRef Gilmour J. Adolescent deformities of the acetabulum—an investigation into the nature of protrusio. Br J Surg 1938; 26: 670–699.CrossRef
7.
Zurück zum Zitat MacDonald D. Primary protrusio acetabui—report of an affected family. J Bone Jt Surg 1971; 53B: 30–36. MacDonald D. Primary protrusio acetabui—report of an affected family. J Bone Jt Surg 1971; 53B: 30–36.
8.
Zurück zum Zitat Gusis SE, Babini JC, Garay SM, Garcia Morteo O, Maldonado Cocco JA. Evaluation of the measurement methods for protrusio acetabuli in normal children. Skelet Radiol 1990; 19: 279–282.CrossRef Gusis SE, Babini JC, Garay SM, Garcia Morteo O, Maldonado Cocco JA. Evaluation of the measurement methods for protrusio acetabuli in normal children. Skelet Radiol 1990; 19: 279–282.CrossRef
9.
Zurück zum Zitat Gates HS III, Poletti SC, Callaghan JJ, McCollum DE. Radiographic measurements in protrusio acetabuli. J Arthroplast 1989; 4 (4): 347–351.CrossRef Gates HS III, Poletti SC, Callaghan JJ, McCollum DE. Radiographic measurements in protrusio acetabuli. J Arthroplast 1989; 4 (4): 347–351.CrossRef
10.
Zurück zum Zitat Kuhlman JE, Scott WW, Fishman EK, Pyeritz RE, Siegelman SS. Acetabular protrusion in Marfan’s syndrome. Radiology 1987; 164: 415–417.PubMed Kuhlman JE, Scott WW, Fishman EK, Pyeritz RE, Siegelman SS. Acetabular protrusion in Marfan’s syndrome. Radiology 1987; 164: 415–417.PubMed
11.
Zurück zum Zitat Wenger DR, Ditkoff TJ, Herring JA, Mauldin DM. Protrusio acetabuli in Marfan’s syndrome. Clin Orthop Relat Res 1980; 147: 134–138.PubMed Wenger DR, Ditkoff TJ, Herring JA, Mauldin DM. Protrusio acetabuli in Marfan’s syndrome. Clin Orthop Relat Res 1980; 147: 134–138.PubMed
12.
Zurück zum Zitat Armbuster TG, Guerra J Jr, Resnick D, Goergen TG, Feingold ML, Niwayama G, Danzig LA. The adult hip: an anatomic study. Radiology 1978; 128: 1–10.PubMed Armbuster TG, Guerra J Jr, Resnick D, Goergen TG, Feingold ML, Niwayama G, Danzig LA. The adult hip: an anatomic study. Radiology 1978; 128: 1–10.PubMed
13.
Zurück zum Zitat Hubbard MJS. The measurement of progression in protrusion acetabuli. Am J Roentgenol 1969; 106: 506–508. Hubbard MJS. The measurement of progression in protrusion acetabuli. Am J Roentgenol 1969; 106: 506–508.
14.
Zurück zum Zitat Alexander CA. The aetiology of primary protrusion acetabuli. Br J Radiol 1965; 38: 567–580.PubMed Alexander CA. The aetiology of primary protrusion acetabuli. Br J Radiol 1965; 38: 567–580.PubMed
15.
Zurück zum Zitat Koehler A. The borderlands of the normal and early pathological in the skiagram (translated from 1st edition by A Turnbull). London: Ballieve, Tindall & Cox; 1928. Koehler A. The borderlands of the normal and early pathological in the skiagram (translated from 1st edition by A Turnbull). London: Ballieve, Tindall & Cox; 1928.
16.
Zurück zum Zitat Sharp IK. Acetabular dysplasia. J Bone Jt Surg 1961; 43B: 268–272. Sharp IK. Acetabular dysplasia. J Bone Jt Surg 1961; 43B: 268–272.
17.
Zurück zum Zitat Hooper JC, Wyn-Jones E. Primary protrusion of the acetabulum. J Bone Jt Surg 1971; 53B: 23–29. Hooper JC, Wyn-Jones E. Primary protrusion of the acetabulum. J Bone Jt Surg 1971; 53B: 23–29.
18.
Zurück zum Zitat Goodman SB, Adler SJ, Fyhrie DP, Schurman DJ. The acetabular teardrop and its relevance to acetabular migration. Clin Orthop Relat Res 1988; 236: 199–204.PubMed Goodman SB, Adler SJ, Fyhrie DP, Schurman DJ. The acetabular teardrop and its relevance to acetabular migration. Clin Orthop Relat Res 1988; 236: 199–204.PubMed
19.
Zurück zum Zitat Ilchmann T, Franzen H, Mjöberg B, Wingstrand H. Measurement accuracy in acetabular cup migration. A comparison of four radiologic methods versus roentgen stereophotogrammetric analysis. J Arthroplast 1992; 7 (2): 121–127.CrossRef Ilchmann T, Franzen H, Mjöberg B, Wingstrand H. Measurement accuracy in acetabular cup migration. A comparison of four radiologic methods versus roentgen stereophotogrammetric analysis. J Arthroplast 1992; 7 (2): 121–127.CrossRef
20.
Zurück zum Zitat Tyler T, Zook L, Brittis D, Gleim G. A new pelvis tilt detection device: roentgenographic validation and application to assessment of hip motion in professional ice hockey players. JOSPT 1996;24 (5): 303–308.PubMed Tyler T, Zook L, Brittis D, Gleim G. A new pelvis tilt detection device: roentgenographic validation and application to assessment of hip motion in professional ice hockey players. JOSPT 1996;24 (5): 303–308.PubMed
21.
Zurück zum Zitat Swallow RA, Naglar E, Roebuck EJ, Whitley AS. Clark’s positioning in radiograp1hy. 11th ed. Boston: Butterworth-Heinemann; 1986. p. 134–135. Swallow RA, Naglar E, Roebuck EJ, Whitley AS. Clark’s positioning in radiograp1hy. 11th ed. Boston: Butterworth-Heinemann; 1986. p. 134–135.
22.
Zurück zum Zitat Warwich R, Williams P. Grays anatomy. 39rd ed. Amsterdam: Elsevier; 2005. p. 1430. Warwich R, Williams P. Grays anatomy. 39rd ed. Amsterdam: Elsevier; 2005. p. 1430.
23.
Zurück zum Zitat Sinnatamby CS. Last’s anatomy. 10th ed. Edinburgh: Churchill-Livingstone; 2003. p. 282. Sinnatamby CS. Last’s anatomy. 10th ed. Edinburgh: Churchill-Livingstone; 2003. p. 282.
24.
Zurück zum Zitat Overgaard K. Otto’s disease and other forms of protrusio acetabuli. Acta Radiol 1935; 16: 390–410.CrossRef Overgaard K. Otto’s disease and other forms of protrusio acetabuli. Acta Radiol 1935; 16: 390–410.CrossRef
25.
Zurück zum Zitat Callaghan JJ, Salvati EA, Pellicci PM, Wilson PD, Ranawat CS. Results of revision for mechanical failure after cemented total hip replacement, 1979 to 1982. J Bone Jt Surg 1985; 67A: 1074–1085. Callaghan JJ, Salvati EA, Pellicci PM, Wilson PD, Ranawat CS. Results of revision for mechanical failure after cemented total hip replacement, 1979 to 1982. J Bone Jt Surg 1985; 67A: 1074–1085.
26.
Zurück zum Zitat Wiberg G. Studies on dysplastic acetabula and congenital subluxation of the hip joint—with special reference to the complications of osteoarthritis. Acta Chirgica Scandinavica 1939; 58 (Suppl): 1–135. Wiberg G. Studies on dysplastic acetabula and congenital subluxation of the hip joint—with special reference to the complications of osteoarthritis. Acta Chirgica Scandinavica 1939; 58 (Suppl): 1–135.
27.
Zurück zum Zitat Heyman CH, Herndon CH. Legg–Perthes disease. J Bone Jt Surg 1950; 32A: 767–778. Heyman CH, Herndon CH. Legg–Perthes disease. J Bone Jt Surg 1950; 32A: 767–778.
28.
Zurück zum Zitat Murphy SB, Ganz R, Muller ME. The prognosis of untreated dysplasia of the hip. J Bone Jt Surg 1995; 77: A985–A989. Murphy SB, Ganz R, Muller ME. The prognosis of untreated dysplasia of the hip. J Bone Jt Surg 1995; 77: A985–A989.
29.
Zurück zum Zitat Golding FC. Protrusi acetabui (central luxation). Br J Surg 1934; 22: 56–62.CrossRef Golding FC. Protrusi acetabui (central luxation). Br J Surg 1934; 22: 56–62.CrossRef
30.
Zurück zum Zitat Tannast M, Murphy SB, Langlotz F, Anderson SE, Siebenrock KA. Estimation of pelvic tilt on anteroposterior X-rays—a comparison of six parameters. Skelet Radiol 2006; 35: 149–155.CrossRef Tannast M, Murphy SB, Langlotz F, Anderson SE, Siebenrock KA. Estimation of pelvic tilt on anteroposterior X-rays—a comparison of six parameters. Skelet Radiol 2006; 35: 149–155.CrossRef
31.
Zurück zum Zitat Anderson N, Humphries N, Wells JE. Measurement error in computed tomography pelvimetry. Australas Radiol 2005; 49 (2): 104–107.PubMedCrossRef Anderson N, Humphries N, Wells JE. Measurement error in computed tomography pelvimetry. Australas Radiol 2005; 49 (2): 104–107.PubMedCrossRef
Metadaten
Titel
A new tilt on pelvic radiographs: a pilot study
verfasst von
P. J. Richards
J. M. Pattison
J. Belcher
R. W. DeCann
Suzanne Anderson
C. Wynn-Jones
Publikationsdatum
01.02.2009
Verlag
Springer-Verlag
Erschienen in
Skeletal Radiology / Ausgabe 2/2009
Print ISSN: 0364-2348
Elektronische ISSN: 1432-2161
DOI
https://doi.org/10.1007/s00256-008-0481-0

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