Inter-Gender Pelvic Shape Variations as a Cause of DDH Overdiagnosis

Khalid M Abdalla,1 Mostafa A Abdelrahman,2 Abdelwahab J Aleshawi,3 Alaha S Al Taweel,1 Majid Bani-Ata,4 Khaled Obeidat5 1Department of Diagnostic Radiology and Nuclear Medicine, Faculty of Medicine, Jordan University of Science and Technology, Irbid 22110, Jordan; 2Department of Allied Medical Scien...

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Main Authors:	Abdalla KM, Abdelrahman MA, Aleshawi AJ, Al Taweel AS, Bani-Ata M, Obeidat K
Format:	article
Language:	EN
Published:	Dove Medical Press 2020
Subjects:	acetabular angle ddh plain x-ray head of the femur Therapeutics. Pharmacology RM1-950
Online Access:	https://doaj.org/article/7d4c3fa3f7f84cf3927371d4b06b83dd
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spelling	oai:doaj.org-article:7d4c3fa3f7f84cf3927371d4b06b83dd2021-12-02T11:04:49ZInter-Gender Pelvic Shape Variations as a Cause of DDH Overdiagnosis1178-203Xhttps://doaj.org/article/7d4c3fa3f7f84cf3927371d4b06b83dd2020-11-01T00:00:00Zhttps://www.dovepress.com/inter-gender-pelvic-shape-variations-as-a-cause-of-ddh-overdiagnosis-peer-reviewed-article-TCRMhttps://doaj.org/toc/1178-203XKhalid M Abdalla,1 Mostafa A Abdelrahman,2 Abdelwahab J Aleshawi,3 Alaha S Al Taweel,1 Majid Bani-Ata,4 Khaled Obeidat5 1Department of Diagnostic Radiology and Nuclear Medicine, Faculty of Medicine, Jordan University of Science and Technology, Irbid 22110, Jordan; 2Department of Allied Medical Sciences, Faculty of Applied Medical Sciences, Jordan University of Science and Technology, Irbid 22110, Jordan; 3Department of Special Surgery, Ophthalmology Division, Jordan University of Science and Technology, Irbid 22110, Jordan; 4Department of Special Surgery, Otolaryngology Division, Faculty of Medicine, Jordan University of Science and Technology, Irbid 22110, Jordan; 5Department of General Surgery, Faculty of Medicine, Jordan University of Science and Technology, Irbid 22110, JordanCorrespondence: Khalid M AbdallaDepartment of Diagnostic Radiology and Nuclear Medicine, Faculty of Medicine, Jordan University of Science and Technology, P. O. Box: 3030, Irbid 22110, JordanTel +962 799273019Fax +962 2 7201064Email khalidmohabdalla@yahoo.comObjective: Developmental dysplasia of the hip (DDH) is an abnormal relationship between the acetabulum and the head of the femur. Plain x-ray of both hips at the age of 3 months is still in use in some countries. On plain films, classic lines and angles are evaluated to meet current guidelines for positive DDH. Among these is the acetabular angle (AA), which most did not exceed 30° in normal pelvis regardless of gender. A flat promontory gives the impression of a high AA angle, whereas a sharp promontory gives the impression of a low AA angle.Materials and Methods: All anteroposterior (AP) pelvic digital x-ray studies performed to rule out DDH were collected from the PACS systems. A novel angle was measured between a line parallel to the lateral aspect of the region of the inferior iliac spines and a line that extends along the acetabular roof to quantify the roundness of the iliac promontory. We called the former line the Miral line and the formed angle the iliac promontory angle.Results: We show that the promontory shape is significantly different between genders, and therefore it is mistaken to generalize an upper AA limit for males and females. In addition, we show that the current guideline of the upper limit of AA did not predict the incidence of DDH.Conclusion: We suggest that the current practice is introducing a high rate of false positive, especially among females, and the current guidelines on AA should be reviewed and assigned separately for males and females. This is more important for countries that did not utilize the ultrasonographic assessment for DDH.Keywords: acetabular angle, DDH, plain x-ray, head of the femurAbdalla KMAbdelrahman MAAleshawi AJAl Taweel ASBani-Ata MObeidat KDove Medical Pressarticleacetabular angleddhplain x-rayhead of the femurTherapeutics. PharmacologyRM1-950ENTherapeutics and Clinical Risk Management, Vol Volume 16, Pp 1075-1080 (2020)
institution	DOAJ
collection	DOAJ
language	EN
topic	acetabular angle ddh plain x-ray head of the femur Therapeutics. Pharmacology RM1-950
spellingShingle	acetabular angle ddh plain x-ray head of the femur Therapeutics. Pharmacology RM1-950 Abdalla KM Abdelrahman MA Aleshawi AJ Al Taweel AS Bani-Ata M Obeidat K Inter-Gender Pelvic Shape Variations as a Cause of DDH Overdiagnosis
description	Khalid M Abdalla,1 Mostafa A Abdelrahman,2 Abdelwahab J Aleshawi,3 Alaha S Al Taweel,1 Majid Bani-Ata,4 Khaled Obeidat5 1Department of Diagnostic Radiology and Nuclear Medicine, Faculty of Medicine, Jordan University of Science and Technology, Irbid 22110, Jordan; 2Department of Allied Medical Sciences, Faculty of Applied Medical Sciences, Jordan University of Science and Technology, Irbid 22110, Jordan; 3Department of Special Surgery, Ophthalmology Division, Jordan University of Science and Technology, Irbid 22110, Jordan; 4Department of Special Surgery, Otolaryngology Division, Faculty of Medicine, Jordan University of Science and Technology, Irbid 22110, Jordan; 5Department of General Surgery, Faculty of Medicine, Jordan University of Science and Technology, Irbid 22110, JordanCorrespondence: Khalid M AbdallaDepartment of Diagnostic Radiology and Nuclear Medicine, Faculty of Medicine, Jordan University of Science and Technology, P. O. Box: 3030, Irbid 22110, JordanTel +962 799273019Fax +962 2 7201064Email khalidmohabdalla@yahoo.comObjective: Developmental dysplasia of the hip (DDH) is an abnormal relationship between the acetabulum and the head of the femur. Plain x-ray of both hips at the age of 3 months is still in use in some countries. On plain films, classic lines and angles are evaluated to meet current guidelines for positive DDH. Among these is the acetabular angle (AA), which most did not exceed 30° in normal pelvis regardless of gender. A flat promontory gives the impression of a high AA angle, whereas a sharp promontory gives the impression of a low AA angle.Materials and Methods: All anteroposterior (AP) pelvic digital x-ray studies performed to rule out DDH were collected from the PACS systems. A novel angle was measured between a line parallel to the lateral aspect of the region of the inferior iliac spines and a line that extends along the acetabular roof to quantify the roundness of the iliac promontory. We called the former line the Miral line and the formed angle the iliac promontory angle.Results: We show that the promontory shape is significantly different between genders, and therefore it is mistaken to generalize an upper AA limit for males and females. In addition, we show that the current guideline of the upper limit of AA did not predict the incidence of DDH.Conclusion: We suggest that the current practice is introducing a high rate of false positive, especially among females, and the current guidelines on AA should be reviewed and assigned separately for males and females. This is more important for countries that did not utilize the ultrasonographic assessment for DDH.Keywords: acetabular angle, DDH, plain x-ray, head of the femur
format	article
author	Abdalla KM Abdelrahman MA Aleshawi AJ Al Taweel AS Bani-Ata M Obeidat K
author_facet	Abdalla KM Abdelrahman MA Aleshawi AJ Al Taweel AS Bani-Ata M Obeidat K
author_sort	Abdalla KM
title	Inter-Gender Pelvic Shape Variations as a Cause of DDH Overdiagnosis
title_short	Inter-Gender Pelvic Shape Variations as a Cause of DDH Overdiagnosis
title_full	Inter-Gender Pelvic Shape Variations as a Cause of DDH Overdiagnosis
title_fullStr	Inter-Gender Pelvic Shape Variations as a Cause of DDH Overdiagnosis
title_full_unstemmed	Inter-Gender Pelvic Shape Variations as a Cause of DDH Overdiagnosis
title_sort	inter-gender pelvic shape variations as a cause of ddh overdiagnosis
publisher	Dove Medical Press
publishDate	2020
url	https://doaj.org/article/7d4c3fa3f7f84cf3927371d4b06b83dd
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Inter-Gender Pelvic Shape Variations as a Cause of DDH Overdiagnosis

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