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The Ischial Spine Sign: Does Pelvic Tilt and Rotation Matter?

  • Clinical Research
  • Published:
Clinical Orthopaedics and Related Research®

An Erratum to this article was published on 13 February 2010

Abstract

Although the ischial spine sign (ISS) has been advocated to detect acetabular retroversion, it is unknown whether the sign is valid on anteroposterior (AP) pelvic radiographs with tilted or rotated pelves. We therefore evaluated reliability of the ISS as a tool for diagnosing acetabular retroversion in the presence of considerable pelvic tilt and/or malrotation. We obtained radiographs of 20 cadaver pelves in 19 different malorientations resulting in 380 pelvis images (760 hips) for evaluation. In addition, 129 clinical radiographs of patients’ hips that had varying pelvis orientations were reviewed. We found an overall sensitivity of 81% (90%), specificity of 70% (71%), positive predictive value of 77% (80.7%), and negative predictive value of 75% (85%) in the cadaver (patient) hips. Our data suggest the ISS is a valid tool for diagnosing acetabular retroversion on plain radiographs taken using a standardized technique regardless of the degree of pelvic tilt and rotation.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Inselspital, University of Bern, Murtenstrasse, 3010, Bern, Switzerland

    Diganta K. Kakaty MD, Andreas F. Fischer MD, Klaus A. Siebenrock MD & Moritz Tannast MD

  2. Department of Orthopaedic Surgery, Hospital of the University of Pennsylvania, Philadelphia, PA, USA

    Harish S. Hosalkar MD, MBMS (Orth), FCPS (Orth), DNB (Orth)

Authors
  1. Diganta K. Kakaty MD
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  2. Andreas F. Fischer MD
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  3. Harish S. Hosalkar MD, MBMS (Orth), FCPS (Orth), DNB (Orth)
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  4. Klaus A. Siebenrock MD
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  5. Moritz Tannast MD
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Corresponding author

Correspondence to Moritz Tannast MD.

Additional information

One or more of the authors (KAS, MT) has received funding from the National Center for Competence in Research “Co-Me” of the Swiss National Science Foundation.

Each author certifies that his or her institution has approved the human protocol for this investigation and that all investigations were conducted in conformity with ethical principles of research.

This work was performed at the University of Bern, Bern, Switzerland.

An erratum to this article can be found at http://dx.doi.org/10.1007/s11999-010-1269-9

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Kakaty, D.K., Fischer, A.F., Hosalkar, H.S. et al. The Ischial Spine Sign: Does Pelvic Tilt and Rotation Matter?. Clin Orthop Relat Res 468, 769–774 (2010). https://doi.org/10.1007/s11999-009-1021-5

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  • DOI: https://doi.org/10.1007/s11999-009-1021-5

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