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      Role of magnetic resonance imaging in assessment of acetabular and femoral version in developmental dysplasia of the hip Translated title: Papel da ressonância magnética na avaliação da versão acetabular e femoral na displasia do desenvolvimento do quadril

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          Abstract

          Objective

          To evaluate the role of magnetic resonance imaging (MRI) in the assessment of femoral and acetabular version in developmental dysplasia of the hip (DDH).

          Materials and Methods

          This was a cross-sectional study of 20 consecutive patients with DDH (27 dysplastic hips) who were examined with MRI. In dysplastic and normal hips (DDH and comparison groups, respectively), we evaluated the following parameters: osseous acetabular anteversion (OAA); cartilaginous acetabular anteversion (CAA); femoral anteversion; osseous Mckibbin index (OMI); cartilaginous Mckibbin index (CMI); and the thickness of the anterior and posterior acetabular cartilage.

          Results

          The OAA was significantly greater in the dysplastic hips. The CAA, femoral anteversion, OMI, and CMI did not differ significantly between the normal and dysplastic hips. In the DDH and comparison groups, the OAA was significantly lower than the CAA, the OMI was significantly lower than the CMI, and the posterior acetabular cartilage was significantly thicker than the anterior cartilage.

          Conclusion

          Our findings confirm that MRI is a valuable tool for the assessment of femoral and acetabular version in DDH. Preoperative MRI evaluation has great potential to improve the planning of pelvic and femoral osteotomies.

          Translated abstract

          Objetivo

          Avaliar o papel da ressonância magnética (RM) na avaliação da versão femoral e acetabular na displasia do desenvolvimento do quadril (DDQ).

          Materiais e Métodos

          Estudo transversal de 20 pacientes consecutivos com DDQ (27 quadris displásicos) que foram examinados com RM. Nos quadris displásicos e normais (grupos DDQ e comparação, respectivamente), avaliamos os seguintes parâmetros: anteversão acetabular óssea (AAO), anteversão acetabular cartilaginosa (AAC), anteversão femoral, índice de Mckibbin ósseo (IMO), índice de Mckibbin cartilaginoso (IMC) e espessura da cartilagem acetabular anterior e posterior.

          Resultados

          A AAO foi significativamente maior nos quadris displásicos. A AAC, anteversão femoral, IMO e IMC não diferiram significativamente entre os quadris normais e displásicos. Nos grupos DDQ e comparação, a AAO foi significativamente menor que a AAC, o IMO foi significativamente menor que o IMC, e a cartilagem acetabular posterior foi significativamente mais espessa que a anterior.

          Conclusão

          Nossos achados confirmam que a RM é uma ferramenta valiosa para a avaliação da versão femoral e acetabular na DDQ. A avaliação pré-operatória por RM tem grande potencial para melhorar o planejamento das osteotomias pélvicas e femorais.

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          Most cited references34

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          Acetabular and femoral anteversion: relationship with osteoarthritis of the hip.

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            The effect of femoral and acetabular version on clinical outcomes after arthroscopic femoroacetabular impingement surgery.

            The impact of proximal femoral and combined femoral and acetabular version on patient-reported outcomes after arthroscopic surgery for femoroacetabular impingement (FAI) remains undefined. The purpose of this study was to identify associations of proximal femoral version as well as combined version (McKibbin index) with disease-specific, validated, patient-reported outcomes following arthroscopic correction of symptomatic FAI.
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              Femoral anteversion.

              Biplane roentgenography, axial roentgenography, and fluoroscopy are the usual roentgenographic methods of measuring femoral anteversion. These methods use a strict geometrical definition of anteversion. The computerized tomography method of measuring anteversion that was developed recently, and is now widely used, does not adhere to the accepted definition of anteversion and has not been tested for accuracy in a large series. In the present study, the widely used computerized-tomography method of measuring anteversion was tested on thirty-two femoral specimens. With that method, anteversion was consistently underestimated by an average of 10 degrees compared with direct measurements and was reproducible only to within +/- 3.6 degrees. Therefore, a new method of measuring anteversion using computerized tomography was developed. It was shown to be accurate to +/- 1 degree, as tested on the same specimens. This study demonstrated geometrically why the currently practiced computerized-tomography method of selecting the points that are used to define the axis of the femoral neck is not consistent with geometrical definitions of anteversion. A more accurate method for both defining the axis of the femoral neck and measuring femoral anteversion is described and recommended for clinical use.
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                Author and article information

                Journal
                Radiol Bras
                Radiol Bras
                rb
                Radiologia Brasileira
                Publicação do Colégio Brasileiro de Radiologia e Diagnóstico por Imagem
                0100-3984
                1678-7099
                Sep-Oct 2022
                Sep-Oct 2022
                : 55
                : 5
                : 299-304
                Affiliations
                [1 ] Alexandria University Faculty of Medicine, Alexandria, Egypt.
                Author notes
                Correspondence: Karim Mohamed Elsharkawi, MD. Alexandria University Faculty of Medicine, Department of Radiodiagnosis. Champollion Street, Al Mesallah Shark, Al Attarin, Alexandria Governorate 21131, Egypt. karim.m.elsharkawi@ 123456gmail.com
                Author information
                http://orcid.org/0000-0002-5857-8513
                http://orcid.org/0000-0001-6569-1146
                http://orcid.org/0000-0003-0339-3623
                http://orcid.org/0000-0002-3210-3835
                http://orcid.org/0000-0002-5074-9592
                Article
                10.1590/0100-3984.2021.0133
                9620843
                36320369
                60362cfa-1fb2-4a85-9a91-f1f80b9c1d57

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 22 August 2021
                : 24 December 2021
                Categories
                Original Article

                developmental dysplasia of the hip,magnetic resonance imaging,acetabulum/diagnostic imaging,femur/diagnostic imaging,bone anteversion/diagnostic imaging,displasia do desenvolvimento do quadril,ressonância magnética,acetábulo/diagnóstico por imagem,fêmur/diagnóstico por imagem,anteversão óssea/diagnóstico por imagem

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