Treat, follow-up, or discharge? An aid in sonographic decisions for the borderline centered neonatal/infantile hips Cover

.blurhash-client-img { display: none !important; }

Treat, follow-up, or discharge? An aid in sonographic decisions for the borderline centered neonatal/infantile hips

Journal of Ultrasonography

Volume 24 (2024): Issue 96 (February 2024)

By: Konstantinos Chlapoutakis , Maria Raissaki , Styliani Markatzinou , Nikolaos Skoulikaris , Antonios Galanos , Adam Hatzidakis and Panagiotis Prassopoulos

Open Access

|Feb 2024

Figures & Tables

A. Demonstration of the lines and measurements which were evaluated. B. Schematic representation of major anatomical landmarks. FH – femoral head, L – labrum, IFL – ischiofemoral ligament, BR – bony rim; LLOI – lower limb of the os ilium

Measurement of the pubofemoral distance (PFD)

ROC analysis of the statistically important measurements (A, F, E) as discriminators between type I and type II hips

ROC analysis of the calculated ratios (indices) A/B, C/D, F/D, E/D as discriminators between type I and type II hips

ROC analysis of (C–F)/D index and PFD as discriminators between type I and type II hips

Intra-observer and Inter-observer reliability analysis of the absolute values and the ratios of the measurements

		ICC	95% CI	p-value
A	Intra-observer	0.983	0.96–0.99	<0.0005
A	Inter-observer	0.902	0.78–0.95	<0.0005
B	Intra-observer	0.964	0.92–0.98	<0.0005
B	Inter-observer	0.860	0.71–0.93	<0.0005
C	Intra-observer	0.992	0.98–1.00	<0.0005
C	Inter-observer	0.914	0.82–0.96	<0.0005
D	Intra-observer	0.989	0.98–1.00	<0.0005
D	Inter-observer	0.944	0.88–0.97	<0.0005
E	Intra-observer	0.992	0.98–1.00	<0.0005
E	Inter-observer	0.900	0.79–0.95	<0.0005
F	Intra-observer	0.991	0.98–1.00	<0.0005
F	Inter-observer	0.929	0.83–0.97	<0.0005
F/D	Intra-observer	0.988	0.98–1.00	<0.0005
F/D	Inter-observer	0.922	0.82–0.97	<0.0005
E/D	Intra-observer	0.983	0.97–0.99	<0.0005
E/D	Inter-observer	0.869	0.73–0.94	<0.0005
(C–F)/D	Intra-observer	0.980	0.96–0.99	<0.0005
(C–F)/D	Inter-observer	0.801	0.59–0.91	<0.0005

ROC analysis of the statistically important measurements, the calculated ratios and PFD, as discriminators between type I and type II hips

	AUC	SE	95% CI		p-value	Cut-off point	Sensitivity	Specificity	PPV	NPV
A^*	0.662	0.042	0.58	0.74	<0.005	7.010	75%	50%	–	–
F^*	0.792	0.033	0.73	0.86	<0.005	5.905	75%	70%	55%	85%
E^*	0.691	0.039	0.61	0.77	<0.005	8.47	72%	60%	–	–
A/B^**	0.606	0.044	0.52	0.69	0.020	1.61	68%	48%	–	–
C/D^**	0.502	0.043	0.42	0.59	0.965	0.86	58%	45%	–	–
F/D^**	0.863	0.028	0.81	0.92	<0.005	0.400	83%	71%	60%	88%
E/D^**	0.747	0.038	0.67	0.82	<0.005	0.555	70%	71%	53%	83%
(C–F)/D^***	0.790	0.033	0.73	0.86	<0.005	0.450	82%	67%	54%	88%
PFD^***	0.658	0.043	0.57	0.74	<0.005	2.88	52%	68%	–	–

Comparison of the demographic and clinical characteristics of the study groups

Variables^*		n	%	Hip type		p-value
Gender	Male	86	46.7	Type I (n = 124)	Type II (n = 60)
Gender	Female	98	53.3	Type I (n = 124)	Type II (n = 60)
Mode of delivery	Vaginal birth	71	38.6	48 (38.7%)	23 (38.3%)	1,000
Mode of delivery	Caesarean section	113	61.4	76 (61.3%)	37 (61.7%)	1,000
Positive family history for DDH^**	No	168	91.3	114 (91.9%)	54 (90%)	0.781
Positive family history for DDH^**	Yes	16	8.7	10 (8.1%)	6 (10%)	0.781
Breech presentation	No	172	93.5	113 (91.1%)	59 (98.3%)	0.107
Breech presentation	Yes	12	6.5	11 (8.9%)	1 (1.7%)	0.107
Reduced amniotic fluid at delivery^***	No	157	85.3	103 (83.1%)	54 (90%)	0,269
Reduced amniotic fluid at delivery^***	Yes	27	14.7	21 (16.9%)	6 (10%)	0,269
Clinical examination at birth^****	Negative	178	96.7	120 (96.8%)	58 (96.7%)	1,000
Clinical examination at birth^****	Positive	6	3.3	4 (3.2%)	2 (3.3%)	1,000
Gestational age at delivery (weeks)	Mean ± SD (min–max)	38.4 ± 1.5 (33–41)		7.83 ± 1.93	7.40 ± 1.78	0.378^a
Birth weight (g)		3,129.2 ± 415.4 (1,880–4,250)		3,146.94 ± 439.66	3,092.52 ± 360.66	0.406
Age at examination (weeks)		7.61 ± 1.91 (5.57–14.57)		7.83 ± 1.93	7.40 ± 1.78	0.148^a

Multiple logistic regression analysis

	OR¹	95% CI		p-value
F
>5.91	1.00	–	–	<0.0005
<5.91	7.78	3.57	17.00	<0.0005
F/D
>0.40	1.00	–	–	<0.0005
<0.40	10.64	4.84	23.43	<0.0005
(C–F)/D
<0.450	1.00	–	–	<0.0005
>0.450	10.15	4.53	22.74	<0.0005

Comparison of measurements and calculated ratios between the two hip types

Variables (mm)^*	Hip type		p-value
Variables (mm)^*	I (n = 124)	II (n = 60)	p-value
A^**	7.13 ± 0.78	6.67 ± 0.73	<0.005
B^**	4.36 ± 0.51	4.39 ± 0.45	0.693
C^**	12.69 ± 1.03	12.78 ± 1.02	0.554
D^**	15.02 ± 1.04	15.08 ± 1.05	0.714
F^**	6.43 ± 0.88	5.51 ± 0.68	<0.005
E^**	8.70 ± 0.91	8.08 ± 0.78	<0.005
PFD^***	2.60 ± 0.50	2.90 ± 0.47	<0.005
A/B	1.66 ± 0.30	1.54 ± 0.24	0.020^a
C/D	0.85 ± 0.05	0.85 ± 0.03	0.731
F/D	0.43 ± 0.04	0.37 ± 0.04	<0.005
E/D	0.58 ± 0.05	0.54 ± 0.05	<0.005
(C–F) / D	0.42 ± 0.07	0.48 ± 0.04	<0.005

DOI: https://doi.org/10.15557/jou.2024.0003 | Journal eISSN: 2451-070X | Journal ISSN: 2084-8404

Journal RSS Feed

Language: English

Submitted on: Apr 28, 2023

Accepted on: Jul 21, 2023

Published on: Feb 27, 2024

Published by: MEDICAL COMMUNICATIONS Sp. z o.o.

In partnership with: Paradigm Publishing Services

Publication frequency: 4 issues per year

Keywords:

ultrasonography,

developmental dysplasia of the hip,

Related subjects:

Basic medical science,

Basic medical science, other

© 2024 Konstantinos Chlapoutakis, Maria Raissaki, Styliani Markatzinou, Nikolaos Skoulikaris, Antonios Galanos, Adam Hatzidakis, Panagiotis Prassopoulos, published by MEDICAL COMMUNICATIONS Sp. z o.o.
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License.

Previous article Volume 24 (2024): Issue 96 (February 2024)Next article