Abstract
Accurate and reproducible measurements related to the paediatric hip and pelvis can be challenging. A standardised radiograph requires close attention to positioning of the infant or child to ensure that it is neither rotated nor inclined. Even a minor degree of obliquity can result in great variability of measurement. In the young child several bony landmarks are not yet established and difficulty can be encountered in determining the appropriate point of measurement. Awareness of these issues allows one to employ the best and most readily reproducible measurement at a particular age or stage of development. Although ultrasound plays an important role in evaluation of paediatric hip dysplasia, this is mainly in infants and radiography continues to play an important role in the older child and adult. There are a wide range of measurements available for different clinical scenarios. These will be addressed in this chapter.
This is a preview of subscription content, log in via an institution.
Buying options
Tax calculation will be finalised at checkout
Purchases are for personal use only
Learn about institutional subscriptionsReferences
Agus H, Bicimoglu A, Omeroglu H et al (2002) How should the acetabular angle of Sharp be measured on a pelvic radiograph? J Pediatr Orthop 22:228–231
Astley B (1963) Chromosomal abnormalities in childhood, with particular reference to Turner’s syndrome and mongolism. Br J Radiol 36:2
Ball F, Kommenda K (1968) Sources of error in the roentgen evaluation of the hip in infancy. Ann Radiol (French) 11:299–301
Bar-On E, Meyer S, Harari G, Porat S (1998) Ultrasonography of the hip in developmental hip dysplasia. J Bone Joint Surg 80B(2):321–324
Boniforti FG, Fujii G, Anfliss RD, Benson MKD (1997) The reliability of measurements of pelvic radiographs in infants. J Bone Joint Surg (Br) 79-B:570–575
Broughton NS, Brougham DI, Cole WG, Menelaus MB (1989) Reliability of radiologic measurement in the assessment of the child’s hip. J Bone Joint Surg 71-B:6–8
Caffey J, Ross S (1958) Pelvic bones in infantile mongolism. AJR Am J Roentgenol 80:458
Carney BT, Rogers M, Minter CL (2005) Reliability of acetabular measures in developmental dysplasia of the hip. J Surg Orthop Adv 14:73–76
Cheng JCY, Chan YL, Hui PW, Shen WY, Metreweli C (1994) Ultrasonographic hips morphometry in infants. J Pediatr Orthop 14:24–28
Dias JJ, Thomas IH, Lamont AC, Mody BS, Thompson JR (1993) The reliability of ultrasonographic assessment of neonatal hips. J Bone Joint Surg (Br) 75B(3):479–482
Edgren W (1965) Coxa plana. A clinical and radiological investigation with particular reference to the importance of the metaphyseal changes for the final shape of the proximal part of the femur. Acta Orthop Scand Suppl 84:1–129
Eyring EJ, Bjornson DR, Peterson CA (1965) Early diagnostic and prognostic signs in Legg-Calvé-Perthes disease. Am J Roentgenol Radium Ther Nucl Med 93:382–387
Falliner A, Schwinzer D, Hahne HJ, Hedderich J, Hassenpflug J (2006) Comparing ultrasound measurements of neonatal hips using the methods of Graf and Terjesen. J Bone Joint Surg (Br) 88B:104–106
Faraj S, Atherton WG, Stott NS (2004) Inter- and intra-measurer error in the measurement of Reimers hip migration percentage. J Bone Joint Surg (Br) 86:434–437
Gerscovich EO (1997a) A radiologist’s guide to the imaging in the diagnosis and treatment of developmental dysplasia of the hip. I. Skelet Radiol 26:386–397
Gerscovich EO (1997b) A radiologist’s guide to the imaging in the diagnosis and treatment of developmental dysplasia of the hip. II. Ultrasonography. Skelet Radiol 26:447–456
Graf R (1980) The diagnosis of congenital hip joint dislocation by the ultrasonic compound treatment. Arch Orthop Traum Surg 97:117–133
Graf R (1984) Classification of hip joint dysplasia by means of sonography. Arch Orthop Trauma Surg 102:248–255
Graf R (1987) Guide to sonography of the infant hip. Thieme, New York
Green DW, Mogekwu N, Scher DM (2009) A modification of Klein’s line to improve sensitivity in slipped capital femoral epiphysis. J Pediatr Orthop 29:449–453
Harcke HT, Grissom LE (1990) Performing dynamic sonography of the infant hip. AJR Am J Roentgenol 155:837–844
Heyman CH, Herndon CH (1950) Legg-Perthes disease. J Bone Joint Surg Am 32:767–778
Heyman J, Lundquist A (1931) Symphysis pubis in pregnancy and parturition. Acta Obstetr Gynecol Scand 12:191–226
Hilgenreiner H (1925) Zur fruhdiagnose und fruhbehandlung der angeborenen Huftgelenkverrenkung. Med Klin 21:1385
Holen KJ, Terjesen T, Tegnander A et al (1994) Ultrasound screening for hip dysplasia in newborns. J Pediatr Orthop 14:667–673
Kaniklides C, Dimopoulos P (1996) Radiological measurement of femoral head position in Legg-Calvé-Perthes disease. Acta Radiol 37:863–869
Katada S, Ando K (1984) A roentgenographic evaluation of the indices for hip dysplasia in children influenced by pelvic tilt. In: Ueno R, Akamatsu N, Itami Y, Tagawa H, Yoshino S (eds) The hip: clinical studies and basic research. Elsevier Science, Amsterdam, pp 137–140
Katz JF (1969) Identification of the teardrop figure and acetabular margins on the roentgenogram. Clin Orthop 62:232
Kay RM, Watts HG, Dorey F (1997) Variability in the assessment of acetabular index. J Pediatr Orthop 17:170–173
Kim HT, Kim J II, Yoo C II (2000) Diagnosing childhood acetabular dysplasia using the lateral margin of the Sourcil. J Pediatr Orthop 20(6):709–717
Kitajima M, Mawatari M, Aita K et al (2006) A simple method to determine the pelvic inclination angle based on anteroposterior radiographs. J Orthop Sci 11:342–346
Klein A, Joplin RJ, Reidy JA et al (1951) Roentgenographic features of slipped capital femoral epiphysis. AJR Am J Roentgenol 66:361–374
Loder RT, Blakemore LC, Farley FA, Laidlaw AT (1999) Measurement variability of slipped upper femoral epiphysis. J Orthop Surg 7:33–42
Milani C, Ishida A, Filho JL, Dobashi ET (2000) A new methodology for the measurement of the Wiberg angle in infants under 3 months. J Pediatr Orthop 9:108–113
Millis MB, Share JC (1992) Use of ultrasonography in dysplasia of the immature hip. Clin Orthop Relat Res 274:160–171
Moberg A, Hansson G, Kaniklides C (1999) Acetabulum-head index in children with normal hips.: a radiographic study of 154 hips. J Pediatr Orthop 8:268–270
Morin C, Harcke HT, MacEwen GD (1985) The infant hip: real time US assessment of acetabular development. Radiology 157:673–677
Muecke EC, Currarino G (1968) Congenital widening of the symphysis pubis. Associated clinical disorders and roentgen anatomy of affected bony pelves. AJR Am J Roentgenol 103:179–185
Ogata S, Moriya H, Tsuchia T, Kamegaya M, Someya M (1990) Acetabular cover in congenital dislocation of the hip. J Bone Joint Surg 72-B:190–196
Parrott J, Boyd RN, Dobson F et al (2002) Hip displacement in spastic cerebral palsy: repeatability of radiologic measurement. J Pediatr Orthop 22:660–667
Patel K, Chapman S (1993) Normal Symphysis pubis width in children. Clin Radiol 27:56–57
Perkins G (1928) Signs by which to diagnose congenital dislocation of the hip. Lancet 1:648
Reimers J (1980) The stability of the hip in children. A radiological study of the results of muscle surgery in cerebral palsy. Acta Orthop Scand Suppl 184:1–100
Roposch A, Moreau NM, Uleryk E, Doria AS (2006) Developmental dysplasia of the hip: quality of reporting of diagnostic accuracy for US. Radiology 241:854–860
Rosendahl K, Aslaksen A, Lie RT, Markestad T (1995) Reliability of ultrasound in the early diagnosis of developmental dysplasia of the hip. Pediatr Radiol 25:219–224
Scoles PV, Boyd A, Jones PK (1987) Roentgenographic parameters of the normal infant hip. J Pediatr Orthop 7:656–663
Sharp I (1961) Acetabular dysplasia. The acetabular angle. J Bone Joint Surg 43B:268–272
Shenton EWH (1911) Disease in bone and its detection by the X-rays. Macmillan, London, pp 40–43
Siebenrock KA, Kalbermatten DF, Ganz R (2003) Effect of pelvic tilt on acetabular retroversion: a study of pelves from cadavers. Clin Orthop Relat Res 407:241–248
Simon EA, Saur F, Buerge M et al (2004) Inter-observer agreement of ultrasonographic measurements of alpha and beta angles and the final type classification based on the Graf method. Swiss Med Wkly 134:671–677
Skaggs DL, Karminsky C, Tolo VT, Kay RM, Reynolds RAK (1998) Variability in measurement of acetabular index in normal and dysplastic hips, before and after reduction. J Pediatr Orthop 18:799–801
Smith WS, Badgley CE, Orwig JB, Harper JM (1968) Correlation of postreduction roentgenograms and thirty-one-year follow-up in congenital dislocation of the hip. J Bone Joint Surg Am 50-A:1081–1098
Song FS, McCarthy JJ, MacEwen GD, Fuchs KE, Dulka SE (2008) The incidence of occult dysplasia of the contralateral hip in children with unilateral hip dysplasia. J Pediatr Orthop 28:173–176
Southwick WO (1967) Osteotomy through the lesser trochanter for slipped capital femoral epiphysis. J Bone Joint Surg Am 49:807–835
Spatz DK, Reiger M, Klaumann FM, Stanton RP, Lipton GE (1997) Measurement of acetabular index intra-observer and inter-observer variation. J Pediatr Orthop 17:174–175
Tan L, Aktas S, Copuroglu C, Ozcan M, Ture M (2001) Reliability of radiological parameters measured on anteroposterior pelvis radiographs of patients with developmental dysplasia of the hip. Acta Orthop Belg 67:374–379
Terjesen T (1996) Ultrasound as the primary imaging method in the diagnosis of hip dysplasia in children aged < 2 years. J Pediatr Orthop B 5:123–128
Terjeson T, Bredland T, Berg V (1989) Ultrasound for hip assessment in the newborn. J Bone Joint Surg (Br) 71-B:767–773
Tönnis D (1976) Normal values of the hip joint for the evaluation of X-rays in children and adults. Clin Orthop Relat Res 119:39–47
Vix VA, Ryu CY (1971) The adult symphysis pubis: normal and abnormal. AJR Am J Roentgenol 112:517–525
Wiberg G (1939) Studies on dysplastic acetabula and congenital subluxation of the hip joint. With special reference to the complication of osteoarthritis. Acta Chirurgica Scandinavica, Suppl. 58
Wientroub S, Grill F (2000) Ultrasonography in developmental dysplasia of the hip. Curr Conc Rev J Bone Joint Surg 82(B):1004
Wiig O, Terjesen T, Svenningsen S (2002) Inter-observer reliability of radiographic classifications and measurements in the assessment of Perthes disease. Acta Orthop Scand 73:523–530
Yamamuro T, Chene SH (1975) A radiological study on the development of the hip joint in normal infants. J Jap Orthop Assoc 49:421–439
Zsernaviczky J, Turk G (1975) The beta-angle. A diagnostic sign for the early diagnosis of congenital hip dysplasia. Rofo 123:131–133
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2020 Springer-Verlag GmbH Germany, part of Springer Nature
About this chapter
Cite this chapter
Tyrrell, P.N.M., Karantanas, A.H., Cassar-Pullicino, V.N. (2020). Pelvis/Hip Paediatric. In: Cassar-Pullicino, V., Davies, A. (eds) Measurements in Musculoskeletal Radiology. Medical Radiology(). Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-540-68897-6_11
Download citation
DOI: https://doi.org/10.1007/978-3-540-68897-6_11
Published:
Publisher Name: Springer, Berlin, Heidelberg
Print ISBN: 978-3-540-43853-3
Online ISBN: 978-3-540-68897-6
eBook Packages: MedicineMedicine (R0)