Clinical Orthopaedics and Related Research®

, Volume 471, Issue 7, pp 2233–2237 | Cite as

Lateral Center-edge Angle on Conventional Radiography and Computed Tomography

  • Shafagh Monazzam
  • James D. Bomar
  • Krishna Cidambi
  • Peter Kruk
  • Harish Hosalkar
Basic Research

Abstract

Background

Lateral center-edge angle (LCEA), originally described and validated on AP radiographs, has been used increasingly in CT-based studies, but it is unclear whether the measure is reliable and whether it correlates with that on AP radiographs.

Question/Purposes

We therefore determined: (1) the interobserver and intraobserver reliabilities of the LCEA measured on AP radiographs; (2) the interobserver and intraobserver reliabilities of the LCEA measured on CT scans; and (3) the intermodality correlation of the LCEA between CT and AP radiography.

Methods

We reviewed the AP radiographs and CT scans of 22 patients treated for slipped capital femoral epiphyses. CT scans were reoriented to a neutral pelvic tilt and inclination. Three evaluators measured the LCEA on the unaffected hip on the AP and CT coronal images that corresponded to the center of the acetabulum on the axial slice.

Results

We found an interobserver intraclass correlation (ICC) analysis of 0.84 for the AP radiographs and 0.88 for the CT scans. The intraobserver ICC for the AP radiographs was 0.96, and for the CT scans 0.98. The intermodality ICC for the CT scans and AP radiographs was 0.79, with a lower bound of 0.61 and an upper bound of 0.87.

Conclusions

Our data suggest the LCEA measured on a CT scan is reliable and correlates with the LCEA on AP radiographs.

References

  1. 1.
    Abel MF, Sutherland DH, Wenger DR, Mubarak SJ. Evaluation of CT scans and 3-D reformatted images for quantitative assessment of the hip. J Pediatr Orthop. 1994;14:48–53.PubMedCrossRefGoogle Scholar
  2. 2.
    Armiger RS, Armand M, Lepisto J, Minhas D, Tallroth K, Mears SC, Waites MD, Taylor RH. Evaluation of a computerized measurement technique for joint alignment before and during periacetabular osteotomy. Comput Aided Surg. 2007;12:215–224.PubMedGoogle Scholar
  3. 3.
    Bouttier R, Morvan J, Mazieres B, Rat AC, Ziegler LE, Fardellone P, Fautrel B, Guillemin F, Pouchot J, Roux C, Coste J, Saraux A. Reproducibility of radiographic hip measurements in adults. Joint Bone Spine. 2012 March 23. [Epub ahead of print].Google Scholar
  4. 4.
    Carroll KL, Murray KA, MacLeod LM, Hennessey TA, Woiczik MR, Roach JW. Measurement of the center edge angle and determination of the Severin classification using digital radiography, computer-assisted measurement tools, and a Severin algorithm: intraobserver and interobserver reliability revisited. J Pediatr Orthop. 2011;31:e30–e35.PubMedCrossRefGoogle Scholar
  5. 5.
    Chen L, Boonthathip M, Cardoso F, Clopton P, Resnick D. Acetabulum protrusio and center edge angle: new MR-imaging measurement criteria. A correlative study with measurement derived from conventional radiography. Skeletal Radiol. 2009;38:123–129.PubMedCrossRefGoogle Scholar
  6. 6.
    Colvin AC, Koehler SM, Bird J. Can the change in center-edge angle during pincer trimming be reliably predicted? Clin Orthop Relat Res. 2011;469:1071–1074.PubMedCrossRefGoogle Scholar
  7. 7.
    Delaunay S, Dussault RG, Kaplan PA, Alford BA. Radiographic measurements of dysplastic adult hips. Skeletal Radiol. 1997;26:75–81.PubMedCrossRefGoogle Scholar
  8. 8.
    Dolan MM, Heyworth BE, Bedi A, Duke G, Kelly BT. CT reveals a high incidence of osseous abnormalities in hips with labral tears. Clin Orthop Relat Res. 2011;469:831–838.PubMedCrossRefGoogle Scholar
  9. 9.
    Fowkes LA, Petridou E, Zagorski C, Karuppiah A, Toms AP. Defining a reference range of acetabular inclination and center-edge angle of the hip in asymptomatic individuals. Skeletal Radiol. 2011;40:1427–1434.PubMedCrossRefGoogle Scholar
  10. 10.
    Haddad FS, Garbuz DS, Duncan CP, Janzen DL, Munk PL. CT evaluation of periacetabular osteotomies. J Bone Joint Surg Br. 2000;82:526–531.PubMedCrossRefGoogle Scholar
  11. 11.
    Hansen BJ, Harris MD, Anderson LA, Peters CL, Weiss JA, Anderson AE. Correlation between radiographic measures of acetabular morphology with 3D femoral head coverage in patients with acetabular retroversion. Acta Orthop. 2012;83:233–239.PubMedCrossRefGoogle Scholar
  12. 12.
    Heyworth BE, Dolan MM, Nguyen JT, Chen NC, Kelly BT. Preoperative three-dimensional CT predicts intraoperative findings in hip arthroscopy. Clin Orthop Relat Res. 2012;470:1950–1957.PubMedCrossRefGoogle Scholar
  13. 13.
    Jacobsen S, Romer L, Soballe K. Degeneration in dysplastic hips: a computer tomography study. Skeletal Radiol. 2005;34:778–784.PubMedCrossRefGoogle Scholar
  14. 14.
    Kang AC, Gooding AJ, Coates MH, Goh TD, Armour P, Rietveld J. Computed tomography assessment of hip joints in asymptomatic individuals in relation to femoroacetabular impingement. Am J Sports Med. 2010;38:1160–1165.PubMedCrossRefGoogle Scholar
  15. 15.
    Kutty S, Schneider P, Faris P, Kiefer G, Frizzell B, Park R, Powell JN. Reliability and predictability of the centre-edge angle in the assessment of pincer femoroacetabular impingement. Int Orthop. 2012;36:505–510.PubMedCrossRefGoogle Scholar
  16. 16.
    Mast NH, Impellizzeri F, Keller S, Leunig M. Reliability and agreement of measures used in radiographic evaluation of the adult hip. Clin Orthop Relat Res. 2011;469:188–199.PubMedCrossRefGoogle Scholar
  17. 17.
    Murphy SB, Ganz R, Muller ME. The prognosis in untreated dysplasia of the hip: a study of radiographic factors that predict the outcome. J Bone Joint Surg Am. 1995;77:985–989.PubMedGoogle Scholar
  18. 18.
    Murphy SB, Kijewski PK, Millis MB, Harless A. Acetabular dysplasia in the adolescent and young adult. Clin Orthop Related Res. 1990;261:214–223.Google Scholar
  19. 19.
    Nelitz M, Guenther KP, Gunkel S, Puhl W. Reliability of radiological measurements in the assessment of hip dysplasia in adults. Br J Radiol. 1999;72:331–334.PubMedGoogle Scholar
  20. 20.
    Philippon MJ, Wolff AB, Briggs KK, Zehms CT, Kuppersmith DA. Acetabular rim reduction for the treatment of femoroacetabular impingement correlates with preoperative and postoperative center-edge angle. Arthroscopy. 2010;26:757–761.PubMedCrossRefGoogle Scholar
  21. 21.
    Tallroth K, Lepisto J. Computed tomography measurement of acetabular dimensions: normal values for correction of dysplasia. Acta Orthop. 2006;77:598–602.PubMedCrossRefGoogle Scholar
  22. 22.
    Tan L, Aktas S, Copuroglu C, Ozcan M, Ture M. Reliability of radiological parameters measured on anteroposterior pelvis radiographs of patients with developmental dysplasia of the hip. Acta Orthop Belg. 2001;67:374–379.PubMedGoogle Scholar
  23. 23.
    Tannast M, Mistry S, Steppacher SD, Reichenbach S, Langlotz F, Siebenrock KA, Zheng G. Radiographic analysis of femoroacetabular impingement with Hip2Norm-reliable and validated. J Orthop Res. 2008;26:1199–1205.PubMedCrossRefGoogle Scholar
  24. 24.
    Tannast M, Siebenrock KA, Anderson SE. Femoroacetabular impingement: radiographic diagnosis.What the radiologist should know. AJR Am J Roentgenol. 2007;188:1540–1552.PubMedCrossRefGoogle Scholar
  25. 25.
    Werner CM, Ramseier LE, Ruckstuhl T, Stromberg J, Copeland CE, Turen CH, Rufibach K, Bouaicha S. Normal values of Wiberg’s lateral center-edge angle and Lequesne’s acetabular index: a coxometric update. Skeletal Radiol. 2012;41:1273–1278.PubMedCrossRefGoogle Scholar
  26. 26.
    Wiberg G. Studies on dysplastic acetabula and congenital subluxation of the hip joint: With special referance to the complication of osteoarthritis. Acta Chir Scand Suppl. 1939;83(suppl 58):1–135.Google Scholar

Copyright information

© The Association of Bone and Joint Surgeons® 2012

Authors and Affiliations

  • Shafagh Monazzam
    • 1
  • James D. Bomar
    • 1
  • Krishna Cidambi
    • 1
  • Peter Kruk
    • 2
  • Harish Hosalkar
    • 1
  1. 1.Department of Orthopedic SurgeryRady Children’s Hospital and Health CenterSan DiegoUSA
  2. 2.Department of RadiologyRady Children’s Hospital and Health CenterSan DiegoUSA

Personalised recommendations