Incidencia de displasia del desarrollo de cadera. Estandarizando la radiografía con un dispositivo anti rotatorio «Orthohip»

Introduction

Developmental dysplasia of the hip is a pathology that causes functional sequelae if it is missed or misdiagnosed. AP radiography of the pelvis is the method most used for screening; however, multiple variables alter the result; positioning, environment, patient, etc. The objective was to determine the incidence of developmental dysplasia of the hip using the anti-rotational device, evaluating the agreement between observers with quantitative and qualitative parameters in the radiograph for diagnosis.

Materials and methods

Retrospective observational study of historical cohort including patients between 4 and 9 months of age with AP radiography of the pelvis using the anti-rotational device evaluating only simple dysplasia. For the measurement, the CareStream program and the concordance analysis with the Stata 15 program were used.

Results

One hundred eighty-one radiographs of patients were included, with an incidence of developmental dysplasia of the hip of 9.4% (95% CI: 5.5–14.6), where 29.4% were bilateral, 35.3% of the right hip and 35.3% of the left hip, taking into account 3 or more qualitative parameters, such as the lateral acetabular sclerosis, flat acetabular configuration, line in the external metaphysis, and an irregular rim. A good degree of agreement (kappa greater than 0.6) was found in acetabular sclerosis, left acetabular line and in the final diagnosis (kappa 0.8).

Discussion

The standardization of radiography taking with the use of an anti-rotational device «Orthohip» and qualitative parameters additional to the acetabular index facilitates an adequate diagnosis avoiding the taking of multiple radiographs.

Level of evidence: Level III.