title: The femoral head-neck contour varies as a function of physeal development.
abstract: OBJECTIVE
  The purpose of this study was to investigate whether the femoral head-neck contour, characterised by the alpha angle, varies with the stage of physeal maturation using MRI evaluation of an asymptomatic paediatric population.
  
  
  METHODS
  Paediatric volunteers with asymptomatic hips were recruited to undergo MRI of both hips. Femoral head physes were graded from 1 (completely open) to 6 (completely fused). The femoral head-neck contour was evaluated using the alpha angle, measured at the 3:00 (anterior) and 1:30 (anterosuperior) positions and correlated with physeal grade, with gender sub-analysis performed.
  
  
  RESULTS
  A total of 43 asymptomatic paediatric volunteers (26 male, 17 female) with mean age 13.0 years (eight to 18) were included with review of bilateral hip MRIs. Correlation between the physeal grade and alpha angle was moderate in males at both the 3:00 (r = 0.477, p < 0.001) and 1:30 (r = 0.509, p < 0.001) positions, whereas there was no significant correlation in females. A significant difference was found between the alpha angles of all the physeal grades (3:00, p = 0.030, 1:30, p = 0.005), but only in males, with the angle increasing with higher grades. For physeal grading, the inter-reader reliability was substantial (intraclass correlation coefficient (ICC) = 0.694), and the intra-reader reliability was also substantial (ICC = 0.788).
  
  
  CONCLUSIONS
  The femoral head-neck contour varies and correlates with the stage of physeal development, but only in males, with the alpha angle increasing with progressive physeal maturation. This suggests that gender differences exist in the natural physiological growth, development or remodelling of femoral head-neck junction. In males, pre-physeal fusion may be a critical period of vulnerability for development of morphologic abnormalities of the femoral head-neck junction. Cite this article: Bone Joint Res 2015;4:17-22.
authors: University of Ottawa, 451 Smyth Rd, Ottawa, Ontario, K1H 8M5, Canada.
authors: A
authors: A
authors: Vo
authors: The Ottawa Hospital, 501 Smyth Road, Ottawa, Ontario, K1H 8L6, Canada.
authors: P E
authors: PE
authors: Beaule
authors: The Ottawa Hospital, 501 Smyth Road, Ottawa, Ontario, K1H 8L6, Canada.
authors: M L
authors: ML
authors: Sampaio
authors: Children's Hospital of Eastern Ontario, 401 Smyth Road, Ottawa, Ontario K1H 8L1, Canada.
authors: C
authors: C
authors: Rotaru
authors: The Ottawa Hospital, 501 Smyth Road, Ottawa, Ontario, K1H 8L6, Canada.
authors: K S
authors: KS
authors: Rakhra
keywords: Cam; Femoroacetabular impingement; Femur; Physis