Skip to main content
Top
Published in: Clinical Orthopaedics and Related Research® 3/2013

01-03-2013 | Clinical Research

Can Radiographic Morphometric Parameters for the Hip Be Assessed on MRI?

Authors: David Stelzeneder, MD, Andreas Hingsammer, MD, Sarah D. Bixby, MD, Young-Jo Kim, MD, PhD

Published in: Clinical Orthopaedics and Related Research® | Issue 3/2013

Login to get access

Abstract

Background

Although morphometric hip parameters measured on radiographs are valuable tools guiding diagnosis and therapy in patients with hip disorders, some clinicians use MRI for such measurements, although it is unclear whether the parameters assessed on MRI differ from those assessed on radiographs.

Questions/purposes

We asked whether the lateral center-edge angle (LCE), Tönnis angle, extrusion index, and anterior center-edge angle (ACE) are similar on MRI and radiography.

Methods

We retrospectively reviewed the imaging data of 103 hips from 103 patients: 46 with femoroacetabular impingement and 57 with hip dysplasia. We manually measured the LCE, Tönnis angle, extrusion index, and ACE from radiographs and MRI in all 103 hips. Four straight coronal (Ant-10 mm, Ant-5 mm, Center, and Post-5 mm), three straight sagittal (S-Med-5 mm, S-Center, S-Lat-5 mm), and three 25º oblique sagittal (OS-Med-5 mm, OS-Center, OS-Lat-5 mm) reformats were reconstructed from a three-dimensional isotropic morphologic MRI sequence. MRI measurements were compared against the gold standard radiographic measurements.

Results

We found good agreement for the LCE angle, Tönnis angle, and extrusion index between radiographic and coronal slice MRI measurements. The mean differences between radiographic and MRI measurements were 5º or less or 5% or less (for the extrusion index) in all coronal MRI slices. However, the differences between ACE angles on sagittal MRI slices and radiographs ranged from 5° to 28º.

Conclusions

LCE, Tönnis angle, and extrusion index can be measured on MRI with comparable results to radiography. The ACE angle on radiographs cannot be estimated reliably from MRI.

Clinical Relevance

MRI provides similar morphometric measurements as radiography for most hip parameters, except for the ACE angle.
Literature
1.
go back to reference Anderson LA, Gililland J, Pelt C, Linford S, Stoddard GJ, Peters CL. Center edge angle measurement for hip preservation surgery: technique and caveats. Orthopedics. 2011;34:86.PubMed Anderson LA, Gililland J, Pelt C, Linford S, Stoddard GJ, Peters CL. Center edge angle measurement for hip preservation surgery: technique and caveats. Orthopedics. 2011;34:86.PubMed
2.
go back to reference Beaule PE, Allen DJ, Clohisy JC, Schoenecker PL, Leunig M. The young adult with hip impingement: deciding on the optimal intervention. Instr Course Lect. 2009;58:213–222.PubMed Beaule PE, Allen DJ, Clohisy JC, Schoenecker PL, Leunig M. The young adult with hip impingement: deciding on the optimal intervention. Instr Course Lect. 2009;58:213–222.PubMed
3.
go back to reference Beck M, Kalhor M, Leunig M, Ganz R. Hip morphology influences the pattern of damage to the acetabular cartilage: femoroacetabular impingement as a cause of early osteoarthritis of the hip. J Bone Joint Surg Br. 2005;87:1012–1018.PubMedCrossRef Beck M, Kalhor M, Leunig M, Ganz R. Hip morphology influences the pattern of damage to the acetabular cartilage: femoroacetabular impingement as a cause of early osteoarthritis of the hip. J Bone Joint Surg Br. 2005;87:1012–1018.PubMedCrossRef
4.
go back to reference Chosa E, Tajima N. Anterior acetabular head index of the hip on false-profile views: new index of anterior acetabular cover. J Bone Joint Surg Br. 2003;85:826–829.PubMed Chosa E, Tajima N. Anterior acetabular head index of the hip on false-profile views: new index of anterior acetabular cover. J Bone Joint Surg Br. 2003;85:826–829.PubMed
5.
go back to reference Clohisy JC, Carlisle JC, Beaule PE, Kim YJ, Trousdale RT, Sierra RJ, Leunig M, Schoenecker PL, Millis MB. A systematic approach to the plain radiographic evaluation of the young adult hip. J Bone Joint Surg Am. 2008;90(suppl 4):47–66.PubMedCrossRef Clohisy JC, Carlisle JC, Beaule PE, Kim YJ, Trousdale RT, Sierra RJ, Leunig M, Schoenecker PL, Millis MB. A systematic approach to the plain radiographic evaluation of the young adult hip. J Bone Joint Surg Am. 2008;90(suppl 4):47–66.PubMedCrossRef
6.
go back to reference Clohisy JC, Carlisle JC, Trousdale R, Kim YJ, Beaule PE, Morgan P, Steger-May K, Schoenecker PL, Millis M. Radiographic evaluation of the hip has limited reliability. Clin Orthop Relat Res. 2009;467:666–675.PubMedCrossRef Clohisy JC, Carlisle JC, Trousdale R, Kim YJ, Beaule PE, Morgan P, Steger-May K, Schoenecker PL, Millis M. Radiographic evaluation of the hip has limited reliability. Clin Orthop Relat Res. 2009;467:666–675.PubMedCrossRef
7.
go back to reference Cooperman DR, Wallensten R, Stulberg SD. Acetabular dysplasia in the adult. Clin Orthop Relat Res. 1983;175:79–85.PubMed Cooperman DR, Wallensten R, Stulberg SD. Acetabular dysplasia in the adult. Clin Orthop Relat Res. 1983;175:79–85.PubMed
8.
go back to reference Crockarell JR Jr, Trousdale RT, Guyton JL. The anterior centre-edge angle: a cadaver study. J Bone Joint Surg Br. 2000;82:532–534.PubMedCrossRef Crockarell JR Jr, Trousdale RT, Guyton JL. The anterior centre-edge angle: a cadaver study. J Bone Joint Surg Br. 2000;82:532–534.PubMedCrossRef
9.
go back to reference Delaunay S, Dussault RG, Kaplan PA, Alford BA. Radiographic measurements of dysplastic adult hips. Skeletal Radiol. 1997;26:75–81.PubMedCrossRef Delaunay S, Dussault RG, Kaplan PA, Alford BA. Radiographic measurements of dysplastic adult hips. Skeletal Radiol. 1997;26:75–81.PubMedCrossRef
10.
go back to reference Domayer SE, Ziebarth K, Chan J, Bixby S, Mamisch TC, Kim YJ. Femoroacetabular cam-type impingement: diagnostic sensitivity and specificity of radiographic views compared to radial MRI. Eur J Radiol. 2011;80:805–810.PubMedCrossRef Domayer SE, Ziebarth K, Chan J, Bixby S, Mamisch TC, Kim YJ. Femoroacetabular cam-type impingement: diagnostic sensitivity and specificity of radiographic views compared to radial MRI. Eur J Radiol. 2011;80:805–810.PubMedCrossRef
11.
go back to reference 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.PubMedCrossRef 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.PubMedCrossRef
12.
go back to reference Fujii M, Nakashima Y, Yamamoto T, Mawatari T, Motomura G, Matsushita A, Matsuda S, Jingushi S, Iwamoto Y. Acetabular retroversion in developmental dysplasia of the hip. J Bone Joint Surg Am. 2010;92:895–903.PubMedCrossRef Fujii M, Nakashima Y, Yamamoto T, Mawatari T, Motomura G, Matsushita A, Matsuda S, Jingushi S, Iwamoto Y. Acetabular retroversion in developmental dysplasia of the hip. J Bone Joint Surg Am. 2010;92:895–903.PubMedCrossRef
13.
go back to reference Ganz R, Leunig M, Leunig-Ganz K, Harris WH. The etiology of osteoarthritis of the hip: an integrated mechanical concept. Clin Orthop Relat Res. 2008;466:264–272.PubMedCrossRef Ganz R, Leunig M, Leunig-Ganz K, Harris WH. The etiology of osteoarthritis of the hip: an integrated mechanical concept. Clin Orthop Relat Res. 2008;466:264–272.PubMedCrossRef
14.
go back to reference Ganz R, Parvizi J, Beck M, Leunig M, Notzli H, Siebenrock KA. Femoroacetabular impingement: a cause for osteoarthritis of the hip. Clin Orthop Relat Res. 2003;417:112–120.PubMed Ganz R, Parvizi J, Beck M, Leunig M, Notzli H, Siebenrock KA. Femoroacetabular impingement: a cause for osteoarthritis of the hip. Clin Orthop Relat Res. 2003;417:112–120.PubMed
15.
go back to reference Ito K, Minka MA 2nd, Leunig M, Werlen S, Ganz R. Femoroacetabular impingement and the cam-effect: a MRI-based quantitative anatomical study of the femoral head-neck offset. J Bone Joint Surg Br. 2001;83:171–176.PubMedCrossRef Ito K, Minka MA 2nd, Leunig M, Werlen S, Ganz R. Femoroacetabular impingement and the cam-effect: a MRI-based quantitative anatomical study of the femoral head-neck offset. J Bone Joint Surg Br. 2001;83:171–176.PubMedCrossRef
16.
go back to reference Jamali AA, Mladenov K, Meyer DC, Martinez A, Beck M, Ganz R, Leunig M. Anteroposterior pelvic radiographs to assess acetabular retroversion: high validity of the “cross-over-sign”. J Orthop Res. 2007;25:758–765.PubMedCrossRef Jamali AA, Mladenov K, Meyer DC, Martinez A, Beck M, Ganz R, Leunig M. Anteroposterior pelvic radiographs to assess acetabular retroversion: high validity of the “cross-over-sign”. J Orthop Res. 2007;25:758–765.PubMedCrossRef
17.
go back to reference Jessel RH, Zurakowski D, Zilkens C, Burstein D, Gray ML, Kim YJ. Radiographic and patient factors associated with pre-radiographic osteoarthritis in hip dysplasia. J Bone Joint Surg Am. 2009;91:1120–1129.PubMedCrossRef Jessel RH, Zurakowski D, Zilkens C, Burstein D, Gray ML, Kim YJ. Radiographic and patient factors associated with pre-radiographic osteoarthritis in hip dysplasia. J Bone Joint Surg Am. 2009;91:1120–1129.PubMedCrossRef
18.
go back to reference Kappe T, Kocak T, Reichel H, Fraitzl CR. Can femoroacetabular impingement and hip dysplasia be distinguished by clinical presentation and patient history? Knee Surg Sports Traumatol Arthrosc. 2012;20:387–392.PubMedCrossRef Kappe T, Kocak T, Reichel H, Fraitzl CR. Can femoroacetabular impingement and hip dysplasia be distinguished by clinical presentation and patient history? Knee Surg Sports Traumatol Arthrosc. 2012;20:387–392.PubMedCrossRef
19.
go back to reference Kim YJ, Bixby S, Mamisch TC, Clohisy JC, Carlisle JC. Imaging structural abnormalities in the hip joint: instability and impingement as a cause of osteoarthritis. Semin Musculoskelet Radiol. 2008;12:334–345.PubMedCrossRef Kim YJ, Bixby S, Mamisch TC, Clohisy JC, Carlisle JC. Imaging structural abnormalities in the hip joint: instability and impingement as a cause of osteoarthritis. Semin Musculoskelet Radiol. 2008;12:334–345.PubMedCrossRef
20.
go back to reference Lequesne M. [Coxometry: measurement of the basic angles of the adult radiographic hip by a combined protractor][in French]. Rev Rhum Mal Osteoartic. 1963;30:479–485.PubMed Lequesne M. [Coxometry: measurement of the basic angles of the adult radiographic hip by a combined protractor][in French]. Rev Rhum Mal Osteoartic. 1963;30:479–485.PubMed
21.
go back to reference Lequesne M, de Seze S. [False profile of the pelvis: a new radiographic incidence for the study of the hip. Its use in dysplasias and different coxopathies][in French]. Rev Rhum Mal Osteoartic. 1961;28:643–652.PubMed Lequesne M, de Seze S. [False profile of the pelvis: a new radiographic incidence for the study of the hip. Its use in dysplasias and different coxopathies][in French]. Rev Rhum Mal Osteoartic. 1961;28:643–652.PubMed
22.
go back to reference Leunig M, Ganz R. [The Bernese method of periacetabular osteotomy][in German]. Orthopade. 1998;27:743–750.PubMed Leunig M, Ganz R. [The Bernese method of periacetabular osteotomy][in German]. Orthopade. 1998;27:743–750.PubMed
23.
go back to reference Leunig M, Huff TW, Ganz R. Femoroacetabular impingement: treatment of the acetabular side. Instr Course Lect. 2009;58:223–229.PubMed Leunig M, Huff TW, Ganz R. Femoroacetabular impingement: treatment of the acetabular side. Instr Course Lect. 2009;58:223–229.PubMed
24.
go back to reference Li PL, Ganz R. Morphologic features of congenital acetabular dysplasia: one in six is retroverted. Clin Orthop Relat Res. 2003;416:245–253.PubMedCrossRef Li PL, Ganz R. Morphologic features of congenital acetabular dysplasia: one in six is retroverted. Clin Orthop Relat Res. 2003;416:245–253.PubMedCrossRef
25.
go back to reference Locher S, Werlen S, Leunig M, Ganz R. [Inadequate detectability of early stages of coxarthrosis with conventional roentgen images][in German]. Z Orthop Ihre Grenzgeb. 2001;139:70–74.PubMedCrossRef Locher S, Werlen S, Leunig M, Ganz R. [Inadequate detectability of early stages of coxarthrosis with conventional roentgen images][in German]. Z Orthop Ihre Grenzgeb. 2001;139:70–74.PubMedCrossRef
26.
go back to reference Mast JW, Brunner RL, Zebrack J. Recognizing acetabular version in the radiographic presentation of hip dysplasia. Clin Orthop Relat Res. 2004;418:48–53.PubMedCrossRef Mast JW, Brunner RL, Zebrack J. Recognizing acetabular version in the radiographic presentation of hip dysplasia. Clin Orthop Relat Res. 2004;418:48–53.PubMedCrossRef
27.
go back to reference 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.PubMedCrossRef 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.PubMedCrossRef
28.
go back to reference Mose K. Methods of measuring in Legg-Calve-Perthes disease with special regard to the prognosis. Clin Orthop Relat Res. 1980;150:103–109.PubMed Mose K. Methods of measuring in Legg-Calve-Perthes disease with special regard to the prognosis. Clin Orthop Relat Res. 1980;150:103–109.PubMed
29.
go back to reference 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.PubMed 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.PubMed
30.
go back to reference Reynolds D, Lucas J, Klaue K. Retroversion of the acetabulum: a cause of hip pain. J Bone Joint Surg Br. 1999;81:281–288.PubMedCrossRef Reynolds D, Lucas J, Klaue K. Retroversion of the acetabulum: a cause of hip pain. J Bone Joint Surg Br. 1999;81:281–288.PubMedCrossRef
31.
go back to reference Sakai T, Nishii T, Sugamoto K, Yoshikawa H, Sugano N. Is vertical-center-anterior angle equivalent to anterior coverage of the hip? Clin Orthop Relat Res. 2009;467:2865–2871.PubMedCrossRef Sakai T, Nishii T, Sugamoto K, Yoshikawa H, Sugano N. Is vertical-center-anterior angle equivalent to anterior coverage of the hip? Clin Orthop Relat Res. 2009;467:2865–2871.PubMedCrossRef
32.
go back to reference Tannast M, Siebenrock KA, Anderson SE. [Femoroacetabular impingement: radiographic diagnosis–what the radiologist should know][in Spanish]. Radiologia. 2008;50:271–284.PubMedCrossRef Tannast M, Siebenrock KA, Anderson SE. [Femoroacetabular impingement: radiographic diagnosis–what the radiologist should know][in Spanish]. Radiologia. 2008;50:271–284.PubMedCrossRef
33.
go back to reference Toennis D. [On changes in the acetabular vault angle of the hip joint in rotated and tilted positions of the pelvis in children][in German]. Z Orthop Ihre Grenzgeb. 1962;96:462–478.PubMed Toennis D. [On changes in the acetabular vault angle of the hip joint in rotated and tilted positions of the pelvis in children][in German]. Z Orthop Ihre Grenzgeb. 1962;96:462–478.PubMed
34.
go back to reference Treguier C, Chapuis M, Branger B, Grellier A, Chouklati K, Bruneau B, Fraisse B, Violas P, Pladys P, Darnault P, Gandon Y. [Developmental dysplasia of the hip][in French]. J Radiol. 2011;92:481–493.PubMedCrossRef Treguier C, Chapuis M, Branger B, Grellier A, Chouklati K, Bruneau B, Fraisse B, Violas P, Pladys P, Darnault P, Gandon Y. [Developmental dysplasia of the hip][in French]. J Radiol. 2011;92:481–493.PubMedCrossRef
35.
go back to reference Wiberg G. Studies on dysplastic acetabula and congenital subluxation of the hip joint. Acta Chir Scand 1939. 1939;58:5–135. Wiberg G. Studies on dysplastic acetabula and congenital subluxation of the hip joint. Acta Chir Scand 1939. 1939;58:5–135.
Metadata
Title
Can Radiographic Morphometric Parameters for the Hip Be Assessed on MRI?
Authors
David Stelzeneder, MD
Andreas Hingsammer, MD
Sarah D. Bixby, MD
Young-Jo Kim, MD, PhD
Publication date
01-03-2013
Publisher
Springer-Verlag
Published in
Clinical Orthopaedics and Related Research® / Issue 3/2013
Print ISSN: 0009-921X
Electronic ISSN: 1528-1132
DOI
https://doi.org/10.1007/s11999-012-2654-3

Other articles of this Issue 3/2013

Clinical Orthopaedics and Related Research® 3/2013 Go to the issue

Symposium: Highlights from the First Combined 2011 Meeting of the Musculoskeletal Tumor Society and Connective Tissue Oncology Society

Using the CUSUM Test to Control the Proportion of Inadequate Open Biopsies of Musculoskeletal Tumors

Symposium: Highlights from the First Combined 2011 Meeting of the Musculoskeletal Tumor Society and Connective Tissue Oncology Society

Lymphadenectomy and Histologic Subtype Affect Overall Survival of Soft Tissue Sarcoma Patients With Nodal Metastases

Symposium: Papers Presented at the 2011 ISOLS Meeting in Beijing, China

Which Implant Is Best After Failed Treatment for Pathologic Femur Fractures?

Symposium: Highlights from the First Combined 2011 Meeting of the Musculoskeletal Tumor Society and Connective Tissue Oncology Society

Lipid-functionalized Dextran Nanosystems to Overcome Multidrug Resistance in Cancer: A Pilot Study