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Published in: Pediatric Radiology 3/2015

01-03-2015 | Original Article

Three-dimensional quantitative analysis of the proximal femur and the pelvis in children and adolescents using an upright biplanar slot-scanning X-ray system

Authors: Kinga Szuper, Ádám Tibor Schlégl, Eleonóra Leidecker, Csaba Vermes, Szabolcs Somoskeöy, Péter Than

Published in: Pediatric Radiology | Issue 3/2015

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Abstract

Background

The anatomy and biomechanics of the pelvis and lower limbs play a key role in the development of orthopaedic disorders.

Objective

This study aimed to establish normal reference standards for the measurement of gender-specific pelvic and femoral parameters in children and adolescents with the EOS 2-D/3-D system.

Materials and methods

EOS 2-D images of 508 individuals (ages 4-16 years) were obtained as part of routine diagnostics. Patients with lower limb abnormalities were excluded. Pelvic and femoral surface 3-D models were generated and clinical parameters calculated by sterEOS 3-D reconstruction software. Data were evaluated using Spearman correlation, paired-samples and independent-samples t-test and linear regression analysis.

Results

Changes in anatomical parameters were found to correlate with age and gender in 1) femoral mechanical axis length: 27.3-43.7 cm (males), 25.5-41.2 cm (females), 2) femoral head diameter: 29.4-46.1 mm (males), 27.7-41.3 mm (females), 3) femoral offset: 26.8-42.4 mm (males), 25.5-37.9 mm (females) and 4) femoral neck length: 35.1-52.9 mm (males), 32.8-48.1 mm (females). There was no gender-specific correlation for the neck shaft angle with values from 130.4° to 129.3°, for femoral torsion (22.5°-19.4°), for sacral slope (39.0°-44.4°) and for lateral pelvic tilt (5.1 mm-6.2 mm). Sagittal pelvic tilt exhibited no significant correlation with age showing average values of 6.5°.

Conclusions

The EOS 2-D/3-D system proved to be a valuable method in the evaluation of female and male developmental changes in pelvic and lower limb anatomical parameters, in normal individuals younger than 16 years of age.
Literature
1.
go back to reference Birkenmaier C, Jorysz G, Jansson V et al (2010) Normal development of the hip: a geometrical analysis based on planimetric radiography. J Pediatr Orthop B 19:1–8CrossRefPubMed Birkenmaier C, Jorysz G, Jansson V et al (2010) Normal development of the hip: a geometrical analysis based on planimetric radiography. J Pediatr Orthop B 19:1–8CrossRefPubMed
3.
go back to reference Byrne DP, Mulhall KJ, Baker JF (2010) Anatomy & biomechanics of the hip. Open Sports Med J 4:51–57CrossRef Byrne DP, Mulhall KJ, Baker JF (2010) Anatomy & biomechanics of the hip. Open Sports Med J 4:51–57CrossRef
4.
go back to reference Campbell JD, Higgs R, Wright K et al (2001) Pelvis, hip and thigh injuries. In: Schenck RC, Guskiewicz KM, Holmes CF (eds) Athletic training and sports medicine. American Academy of Orthopaedic Surgeons, Rosemount, p 399 Campbell JD, Higgs R, Wright K et al (2001) Pelvis, hip and thigh injuries. In: Schenck RC, Guskiewicz KM, Holmes CF (eds) Athletic training and sports medicine. American Academy of Orthopaedic Surgeons, Rosemount, p 399
5.
go back to reference Johnston JD, Noble PC, Hurwitz DE et al (1998) Biomechanics of the hip. In: Callaghan J, Rosenberg AG, Rubas HE (eds) The adult hip, 1st edn. LWW, Philadelphia, pp 81–90 Johnston JD, Noble PC, Hurwitz DE et al (1998) Biomechanics of the hip. In: Callaghan J, Rosenberg AG, Rubas HE (eds) The adult hip, 1st edn. LWW, Philadelphia, pp 81–90
6.
go back to reference Charpak G (1996) Prospects for the use in medicine of new detectors of ionizing radiation. Bull Acad Natl Med 180:161–168, discussion 168–169PubMed Charpak G (1996) Prospects for the use in medicine of new detectors of ionizing radiation. Bull Acad Natl Med 180:161–168, discussion 168–169PubMed
7.
go back to reference Charpak G, Bouclier R, Bressani T et al (1968) The use of multiwire proportional counters to select and localize charged particles. Nucl Inst Methods 62:262–268CrossRef Charpak G, Bouclier R, Bressani T et al (1968) The use of multiwire proportional counters to select and localize charged particles. Nucl Inst Methods 62:262–268CrossRef
10.
go back to reference Deschenes S, Charron G, Beaudoin G et al (2010) Diagnostic imaging of spinal deformities: reducing patients radiation dose with a new slot-scanning X-ray imager. Spine 35:989–994CrossRefPubMed Deschenes S, Charron G, Beaudoin G et al (2010) Diagnostic imaging of spinal deformities: reducing patients radiation dose with a new slot-scanning X-ray imager. Spine 35:989–994CrossRefPubMed
11.
go back to reference Dietrich TJ, Pfirrmann CW, Schwab A et al (2013) Comparison of radiation dose, workflow, patient comfort and financial break-even of standard digital radiography and a novel biplanar low-dose X-ray system for upright full-length lower limb and whole spine radiography. Skelet Radiol 42:959–967CrossRef Dietrich TJ, Pfirrmann CW, Schwab A et al (2013) Comparison of radiation dose, workflow, patient comfort and financial break-even of standard digital radiography and a novel biplanar low-dose X-ray system for upright full-length lower limb and whole spine radiography. Skelet Radiol 42:959–967CrossRef
12.
go back to reference Than P, Szuper K, Warta V et al (2012) Geometrical values of the normal and arthritic hip and knee detected with the EOS imaging system. Int Orthop 36:1291–1297CrossRefPubMedCentralPubMed Than P, Szuper K, Warta V et al (2012) Geometrical values of the normal and arthritic hip and knee detected with the EOS imaging system. Int Orthop 36:1291–1297CrossRefPubMedCentralPubMed
13.
go back to reference Gheno R, Nectoux E, Herbaux B et al (2012) Three-dimensional measurements of the lower extremity in children and adolescents using a low-dose biplanar X-ray device. Eur Radiol 22:765–771CrossRefPubMed Gheno R, Nectoux E, Herbaux B et al (2012) Three-dimensional measurements of the lower extremity in children and adolescents using a low-dose biplanar X-ray device. Eur Radiol 22:765–771CrossRefPubMed
14.
go back to reference Ohl X, Stanchina C, Billuart F et al (2010) Shoulder bony landmarks location using the EOS low-dose stereoradiography system: a reproducibility study. Surg Radiol Anat 32:153–158CrossRefPubMed Ohl X, Stanchina C, Billuart F et al (2010) Shoulder bony landmarks location using the EOS low-dose stereoradiography system: a reproducibility study. Surg Radiol Anat 32:153–158CrossRefPubMed
15.
go back to reference Thelen P, Delin C, Folinais D et al (2012) Evaluation of a new low-dose biplanar system to assess lower-limb alignment in 3D: a phantom study. Skeletal Radiol 41:1287–1293CrossRefPubMed Thelen P, Delin C, Folinais D et al (2012) Evaluation of a new low-dose biplanar system to assess lower-limb alignment in 3D: a phantom study. Skeletal Radiol 41:1287–1293CrossRefPubMed
16.
go back to reference Chaibi Y, Cresson T, Aubert B et al (2012) Fast 3D reconstruction of the lower limb using a parametric model and statistical inferences and clinical measurements calculation from biplanar X-rays. Comput Methods Biomech Biomed Eng 15:457–466CrossRef Chaibi Y, Cresson T, Aubert B et al (2012) Fast 3D reconstruction of the lower limb using a parametric model and statistical inferences and clinical measurements calculation from biplanar X-rays. Comput Methods Biomech Biomed Eng 15:457–466CrossRef
18.
go back to reference Journé A, Sadaka J, Bélicourt C et al (2012) New method for measuring acetabular component positioning with EOS imaging: feasibility study on dry bone. Int Orthop 36:2205–2209CrossRefPubMedCentralPubMed Journé A, Sadaka J, Bélicourt C et al (2012) New method for measuring acetabular component positioning with EOS imaging: feasibility study on dry bone. Int Orthop 36:2205–2209CrossRefPubMedCentralPubMed
19.
go back to reference Guenoun B, Zadegan F, Aim F et al (2012) Reliability of a new method for lower-extremity measurements based on stereoradiographic three-dimensional reconstruction. Orthop Traumatol Surg Res 98:506–513CrossRefPubMed Guenoun B, Zadegan F, Aim F et al (2012) Reliability of a new method for lower-extremity measurements based on stereoradiographic three-dimensional reconstruction. Orthop Traumatol Surg Res 98:506–513CrossRefPubMed
20.
go back to reference Folinais D, Thelen P, Delin C et al (2013) Measuring femoral and rotational alignment: EOS system versus computed tomography. Orthop Traumatol Surg Res 99:509–516CrossRefPubMed Folinais D, Thelen P, Delin C et al (2013) Measuring femoral and rotational alignment: EOS system versus computed tomography. Orthop Traumatol Surg Res 99:509–516CrossRefPubMed
21.
go back to reference Assi A, Chaibi Y, Presedo A et al (2013) Three-dimensional reconstructions for asymptomatic and cerebral palsy children’s lower limbs using a biplanar X-ray system: a feasibility study. Eur J Radiol 82:2359–2364CrossRefPubMed Assi A, Chaibi Y, Presedo A et al (2013) Three-dimensional reconstructions for asymptomatic and cerebral palsy children’s lower limbs using a biplanar X-ray system: a feasibility study. Eur J Radiol 82:2359–2364CrossRefPubMed
22.
go back to reference Gaumétou E, Quijano S, Ilharreborde B et al (2014) EOS analysis of lower extremity segmental torsion in children and young adults. Orthop Traumatol Surg Res 100:147–151CrossRefPubMed Gaumétou E, Quijano S, Ilharreborde B et al (2014) EOS analysis of lower extremity segmental torsion in children and young adults. Orthop Traumatol Surg Res 100:147–151CrossRefPubMed
23.
go back to reference Than P, Sillinger T, Kránicz J et al (2004) Radiographic parameters of the hip joint from birth to adolescence. Pediatr Radiol 34:237–244CrossRefPubMed Than P, Sillinger T, Kránicz J et al (2004) Radiographic parameters of the hip joint from birth to adolescence. Pediatr Radiol 34:237–244CrossRefPubMed
24.
go back to reference Ruff C (2007) Body size prediction from juvenile skeletal remains. Am J Phys Anthropol 133:698–716CrossRefPubMed Ruff C (2007) Body size prediction from juvenile skeletal remains. Am J Phys Anthropol 133:698–716CrossRefPubMed
25.
go back to reference Sabharwal S, Zhao C (2009) The hip-knee-ankle angle in children: reference values based on a full-length standing radiograph. J Bone Joint Surg Am 91:2461–2468CrossRefPubMed Sabharwal S, Zhao C (2009) The hip-knee-ankle angle in children: reference values based on a full-length standing radiograph. J Bone Joint Surg Am 91:2461–2468CrossRefPubMed
26.
go back to reference Winer BJ (1971) Statistical principles in experimental design, 2nd edn. McGraw Hill, New York Winer BJ (1971) Statistical principles in experimental design, 2nd edn. McGraw Hill, New York
27.
go back to reference Azmy C, Guérard S, Bonnet X et al (2010) EOS orthopaedic imaging system to study patellofemoral kinematics: assessment of uncertainty. Orthop Traumatol Surg Res 96:28–36CrossRefPubMed Azmy C, Guérard S, Bonnet X et al (2010) EOS orthopaedic imaging system to study patellofemoral kinematics: assessment of uncertainty. Orthop Traumatol Surg Res 96:28–36CrossRefPubMed
28.
go back to reference Lazennec JY, Rangel A, Baudoin A et al (2011) The EOS imaging system for understanding a patellofemoral disorder following THR. Orthop Traumatol Surg Res 97:98–101CrossRefPubMed Lazennec JY, Rangel A, Baudoin A et al (2011) The EOS imaging system for understanding a patellofemoral disorder following THR. Orthop Traumatol Surg Res 97:98–101CrossRefPubMed
29.
go back to reference Piriou P, Bugyan H, Casalonga D et al (2013) Can hip anatomy be reconstructed with femoral components having only one neck morphology? A study on 466 hips. J Arthroplasty 28:1185–1191CrossRefPubMed Piriou P, Bugyan H, Casalonga D et al (2013) Can hip anatomy be reconstructed with femoral components having only one neck morphology? A study on 466 hips. J Arthroplasty 28:1185–1191CrossRefPubMed
30.
go back to reference Schmitz MR, Bittersohl B, Zaps D et al (2013) Spectrum of radiographic femoroacetabular impingement morphology in adolescents and young adults: an EOS-based double-cohort study. J Bone Joint Surg Am 95:e90CrossRefPubMed Schmitz MR, Bittersohl B, Zaps D et al (2013) Spectrum of radiographic femoroacetabular impingement morphology in adolescents and young adults: an EOS-based double-cohort study. J Bone Joint Surg Am 95:e90CrossRefPubMed
31.
go back to reference Boutry N, Dutouquet B, Leleu X et al (2013) Low-dose biplanar skeletal survey versus digital skeletal survey in multiple myeloma. Eur Radiol 23:2236–2245CrossRefPubMed Boutry N, Dutouquet B, Leleu X et al (2013) Low-dose biplanar skeletal survey versus digital skeletal survey in multiple myeloma. Eur Radiol 23:2236–2245CrossRefPubMed
32.
go back to reference Fabry G, MacEwen GD, Shands AR (1973) Torsion of the femur. A follow-up study in normal and abnormal conditions. J Bone Joint Surg Am 55:1726–1738PubMed Fabry G, MacEwen GD, Shands AR (1973) Torsion of the femur. A follow-up study in normal and abnormal conditions. J Bone Joint Surg Am 55:1726–1738PubMed
33.
go back to reference Hamacher P (1974) Röntgenologische normal werte des hüftgelenks, CCD- und AT-Winkel. Orthop Praxis 10:23–28 Hamacher P (1974) Röntgenologische normal werte des hüftgelenks, CCD- und AT-Winkel. Orthop Praxis 10:23–28
Metadata
Title
Three-dimensional quantitative analysis of the proximal femur and the pelvis in children and adolescents using an upright biplanar slot-scanning X-ray system
Authors
Kinga Szuper
Ádám Tibor Schlégl
Eleonóra Leidecker
Csaba Vermes
Szabolcs Somoskeöy
Péter Than
Publication date
01-03-2015
Publisher
Springer Berlin Heidelberg
Published in
Pediatric Radiology / Issue 3/2015
Print ISSN: 0301-0449
Electronic ISSN: 1432-1998
DOI
https://doi.org/10.1007/s00247-014-3146-2

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