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Journal of Bone and Joint Surgery - British Volume, Vol 85-B, Issue 5, 726-730.
doi: 10.1302/0301-620X.85B5.13893  
Copyright © 2003 by British Editorial Society of Bone and Joint Surgery
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Ultrasonographic screening for developmental dysplasia of the hip in infants

REPRODUCIBILITY OF ASSESSMENTS MADE BY RADIOGRAPHERS

E. A. Roovers, MSc, Epidemiologist1; M. M. Boere-Boonekamp, MD, PhD, Youth Health Care Physician1; T. S. A. Geertsma, MD, Consultant Radiologist2; G. A. Zielhuis, PhD, Professor of Epidemiology3; and A. H. M. Kerkhoff, MD, PhD, MPH, Professor of Public Health1

1 Centre for Health Care Research, University of Twente, PO Box 217, 7500 AE Enschede, The Netherlands.
2 Department of Radiology, Gelderse Vallei Hospital, PO Box 9025, 6710 HN Ede, The Netherlands.
3 Department of Epidemiology and Biostatistics, University Medical Centre Nijmegen, PO Box 9101, 6500 HB Nijmegen, The Netherlands.

Correspondence should be sent to Dr E. A. Roovers.

We studied the reproducibility of ultrasonographic screening examination of the hip when read by diagnostic radiographers. In order to determine interobserver variability, 200 ultrasonograms were classified according to Graf’s method by five observers (four radiographers and one radiologist). The kappa values for interobserver variability indicated moderate agreement (kappa 0.47) for the exact Graf classification and substantial agreement (kappa 0.65) for the classification of normal (type I) versus abnormal (type IIa-IV). Agreement was significantly different for normal, immature and abnormal hips. Comparison of the findings in our interobserver study with existing information based on other examinations and treatment revealed that only a small number of infants with mildly dysplastic hips would have been typed as normal by some observers as a result of observer variability. In conclusion, the interobserver agreement on the ultrasound assessment of the hip was good enough for screening purposes. Observer variability did not result in any severe cases being missed.




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A. Falliner, D. Schwinzer, H.-J. Hahne, J. Hedderich, and J. Hassenpflug
Comparing ultrasound measurements of neonatal hips using the methods of Graf and Terjesen
J Bone Joint Surg Br, January 1, 2006; 88-B(1): 104 - 106.
[Abstract] [Full Text] [PDF]


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Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General