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Automated Dynamic 3D Ultrasound Assessment of Developmental Dysplasia of the Infant Hip

  • Olivia Paserin
  • Kishore Mulpuri
  • Anthony Cooper
  • Antony J. Hodgson
  • Rafeef Garbi
Conference paper
Part of the Lecture Notes in Computer Science book series (LNCS, volume 11404)

Abstract

Dynamic two-dimensional sonography of the infant hip is a commonly used procedure for developmental dysplasia of the hip (DDH) screening by many clinicians. It however has been found to be unreliable with some studies reporting associated misdiagnosis rates of up to \(29\%\). Aiming to improve reliability of diagnosis and to help in standardizing diagnosis across different raters and health-centers, we present a preliminary automated method for assessing hip instability using three-dimensional (3D) dynamic ultrasound (US). To quantify hip assessment, we propose the use of femoral head coverage variability (\(\varDelta FHC_{3D}\)) within US volumes collected during a dynamic scan which uses phase symmetry features to approximate the vertical cortex of the ilium and a random forest classifier to identify the approximate location of the femoral head. We measure the change in \(FHC_{3D}\) across US scans of the hip acquired under posterior stress vs. rest as maneuvered during a 3D dynamic assessment. Our findings on 38 hips from 19 infants scanned by one orthopedic surgeon and two radiology technicians suggests the proposed \(\varDelta FHC_{3D}\) may provide a good degree of repeatability with an average test-retest intraclass correlation measure of 0.70 (\(95\%\) confidence interval: 0.35 to 0.87, \(F(21,21)\,{=}\,7.738\), \(p\,{<}\,0.001\)). This suggests that our 3D dynamic dysplasia metric may prove valuable in improving reliability in diagnosing hip laxity due to DDH, which may lead to a more standardized DDH assessment with better diagnostic accuracy. The long-term significance of this approach to evaluating dynamic assessments may lie in increasing early diagnostic sensitivity in order to prevent dysplasia remaining undetected prior to manifesting itself in early adulthood joint disease.

Keywords

Pediatric Ultrasound Hip Bone imaging Developmental dysplasia of the hip DDH Dynamic assessment Repeatability 

Notes

Acknowledgements

We gratefully acknowledge the support of NVIDIA Corporation with the donation of the Titan X GPU used for this research.

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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Olivia Paserin
    • 1
  • Kishore Mulpuri
    • 2
  • Anthony Cooper
    • 2
  • Antony J. Hodgson
    • 3
  • Rafeef Garbi
    • 1
  1. 1.Department of Electrical and Computer EngineeringUniversity of British ColumbiaVancouverCanada
  2. 2.Department of Orthopaedic SurgeryBritish Columbia Children’s HospitalVancouverCanada
  3. 3.Department of Mechanical EngineeringUniversity of British ColumbiaVancouverCanada

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