title: Reliability of radiographic signs for acetabular retroversion.
abstract: Acetabular retroversion may contribute to femoroacetabular impingement and lead to osteoarthritis of the hip. Retroversion has been measured on computed tomography scans. In recent years, assessment of acetabular version on anteroposterior pelvic views has gained increasing attention. We therefore aimed to determine the reliability of radiographic signs of acetabular retroversion and its association with the rater's experience. Five orthopedic surgeons (o1 to o5) rated the crossover sign, ischial spine sign and posterior wall sign on X-rays of 40 hip joints. Also, we determined the rater's experience in recognizing acetabular retroversion with a questionnaire and correlated intraobserver reliability to the calculated experience score. The intraobserver results were 0.325 (o1), 0.848 (o2), 0.684 (o3), 0.701 (o4), and 1.000 (o5) for the crossover sign, 0.750 (o1), 0.890 (o2), 0.593 (o3), 0.483 (o4), and 0.946 (o5) for the posterior wall sign; and 0.578 (o1), 0.680 (o2), 0.595 (o3), 0.375 (o4), and 0.800 (o5) for the ischial spine sign. Interobserver reliability was 0.514 for the crossover, 0.633 for the posterior, and 0.543 for the ischial spine sign wall. The experience sum score correlated to the kappa results for the crossover (r = 0.527), posterior wall (r = 0.738), and ischial spine sign (r = 0.949). Assessing acetabular version on plain radiographs is subject to intra- and interindividual error and related to the observer's individual experience.
authors.affiliation: Orthopaedic Surgery, University of Ulm, Ulm, Germany. thkappe@gmx.de
authors.forename: Thomas
authors.initials: T
authors.lastname: Kappe
authors.forename: Tugrul
authors.initials: T
authors.lastname: Kocak
authors.forename: Carl
authors.initials: C
authors.lastname: Neuerburg
authors.forename: Sabine
authors.initials: S
authors.lastname: Lippacher
authors.forename: Ralf
authors.initials: R
authors.lastname: Bieger
authors.forename: Heiko
authors.initials: H
authors.lastname: Reichel
mesh_terms: D000077:Acetabulum / Q000000981:diagnostic imaging*; D000293:Adolescent; D000328:Adult; D001175:Arthrography / Q000379:methods*; D017760:Bone Malalignment / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000503:physiopathology; D005260:Female; D006617:Hip Dislocation / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000503:physiopathology; D006621:Hip Joint / Q000000981:diagnostic imaging / Q000503:physiopathology; D006801:Humans; D008297:Male; D015588:Observer Variation; D011237:Predictive Value of Tests; D016059:Range of Motion, Articular; D015203:Reproducibility of Results; D055815:Young Adult
references.citation: Clin Orthop Relat Res. 2010 Mar;468(3):769-74
references.pmid: 19662463
references.citation: J Orthop Res. 2008 Sep;26(9):1199-205
references.pmid: 18404737
references.citation: J Bone Joint Surg Am. 2003 Feb;85(2):278-86
references.pmid: 12571306
references.citation: Clin Orthop Relat Res. 2003 Nov;(416):245-53
references.pmid: 14646767
references.citation: Clin Orthop Relat Res. 2009 Mar;467(3):682-91
references.pmid: 19130159
references.citation: Clin Orthop Relat Res. 2007 May;458:125-30
references.pmid: 17308482
references.citation: J Pediatr Orthop B. 2004 Mar;13(2):81-7
references.pmid: 15076584
references.citation: Clin Orthop Relat Res. 2010 Mar;468(3):846-51
references.pmid: 19588210
references.citation: Clin Orthop Relat Res. 2008 Mar;466(3):677-83
references.pmid: 18264856
references.citation: Clin Orthop Relat Res. 2009 Mar;467(3):666-75
references.pmid: 19048356
references.citation: Clin Orthop Relat Res. 2003 Dec;(417):263-9
references.pmid: 14646725
references.citation: J Bone Joint Surg Am. 2006 Feb;88(2):372-9
references.pmid: 16452750
references.citation: J Orthop Res. 2007 Jun;25(6):758-65
references.pmid: 17343286
references.citation: Int Orthop. 2009 Jun;33(3):625-31
references.pmid: 18157533
references.citation: J Pediatr Orthop B. 2002 Jan;11(1):34-40
references.pmid: 11866079
references.citation: J Bone Joint Surg Br. 2009 Aug;91(8):1031-6
references.pmid: 19651829
references.citation: J Bone Joint Surg Br. 2006 Jun;88(6):727-9
references.pmid: 16720763
references.citation: J Bone Joint Surg Br. 1999 Mar;81(2):281-8
references.pmid: 10204935
references.citation: Clin Orthop Relat Res. 2004 Sep;(426):145-50
references.pmid: 15346066
references.citation: Acta Orthop Belg. 2008 Dec;74(6):766-72
references.pmid: 19205323
references.citation: Clin Orthop Relat Res. 2003 Feb;(407):241-8
references.pmid: 12567152
references.citation: Biometrics. 1977 Mar;33(1):159-74
references.pmid: 843571