scholarly journals Association of the Anatomical Sacral Slope With Lumbar Lordosis and Pelvic Incidence in Female Patients With Developmental Hip Dysplasia: A Retrospective Cross-sectional Study

2020 ◽  
Author(s):  
Norio Imai ◽  
Hayato Suzuki ◽  
Atsushi Sakagami ◽  
Yuki Hirano ◽  
Naoto Endo

Abstract Background:The anatomical sacral slope, considered an anatomical pelvic parameter independent of femoral head centers for measurement, was previously described to strongly correlate withpelvic incidenceon two-dimensional examination of normal healthy subjects. However, the associationbetween anatomical sacral slope and pelvic incidence was unclear in patients withdevelopmental dysplasia of the hip. Thecurrent study aimed to examine the association between anatomical sacral slope and other spinopelvic parameters on plain radiographs in female patients with developmental dysplasia of the hip. Methods:Eighty-four women with developmental dysplasia of the hip were examined. Lumbar lordosis, thoracic kyphosis, pelvic incidence, sacral slope, and anatomical sacral slope, which was deemedthe angle formed by the straight line of the S1 superior endplate and a line at a right angle to the anterior pelvic plane, were determined by plain radiographs. The correlations were examined by Pearson correlation coefficients, and intra- and interrater intraclass correlation coefficients were evaluated forreliability.Results:A strong association was observed between pelvic incidence and anatomical sacral slope (r=0.725, p<0.001). In addition, the association between anatomical sacral slope and lumbar lordosis wassimilar to that between pelvic incidence and lumbar lordosis (r=0.661, p<0.001 and r=0.554, p<0.001, respectively). The intraraterintraclass correlation coefficient values were 0.869 for anatomical sacral slope and 0.824 for pelvic incidence. Furthermore, the interraterintraclass correlation coefficient values were 0.83 for anatomical sacral slope and 0.685 for pelvic incidence. Conclusions:We found that the strong association between anatomical sacral slope and pelvic incidence wasequal to that in normal,healthy subjects. The associationbetweenanatomical sacral slope and lumbar lordosis was equal to that between pelvic incidence and lumbar lordosis. Additionally, the intraclass correlation coefficient value foranatomical sacral slope was slightlyhigher than that forpelvic incidence. We thusconclude that anatomical sacral slope can be considered a helpful anatomical pelvic parameter that isasubstitute for pelvic incidence not only in normal subjectsbut also in patients with developmental dysplasia of the hip.

2020 ◽  
Author(s):  
Norio Imai ◽  
Hayato Suzuki ◽  
Atsushi Sakagami ◽  
Yuki Hirano ◽  
Naoto Endo

Abstract Background: The anatomical sacral slope is considered as an anatomical pelvic parameter independent of femoral head centers for measurement of anatomical sacral slope and was previously described to strongly correlate with pelvic incidence on a two-dimensional examination of healthy subjects. However, the correlation between anatomical sacral slope and pelvic incidence was unclear in patients with developmental dysplasia of the hip. This study aimed to examine the correlation between anatomical sacral slope and other spinopelvic parameters by analyzing plain radiographs of female patients with developmental dysplasia of the hip. Methods: Eighty-four women with developmental dysplasia of the hip were examined. Lumbar lordosis, thoracic kyphosis, pelvic incidence, sacral slope, and anatomical sacral slope (the angle formed by the straight line of the S1 superior endplate and a line at a right angle to the anterior pelvic plane), were determined by analyzing plain radiographs. The correlations were examined by Pearson correlation coefficients, and intra- and inter-rater intraclass correlation coefficients were evaluated for reliability. Results: A strong correlation was observed between pelvic incidence and anatomical sacral slope (r=0.725, p<0.001). In addition, the correlation between anatomical sacral slope and lumbar lordosis was similar to that between pelvic incidence and lumbar lordosis (r=0.661, p<0.001 and r=0.554, p<0.001, respectively). The intra-rater intraclass correlation coefficient values were 0.869 and 0.824 for anatomical sacral slope and pelvic incidence, respectively. Furthermore, the inter-rater intraclass correlation coefficient values were 0.83 and 0.685 for anatomical sacral slope and pelvic incidence, respectively. Conclusions: We observed that the strong correlation between anatomical sacral slope and pelvic incidence in patients with developmental dysplasia of the hip was equal to that in normal healthy subjects. The correlation between anatomical sacral slope and lumbar lordosis was equal to that between pelvic incidence and lumbar lordosis. Additionally, the intraclass correlation coefficient values for the anatomical sacral slope were slightly higher than those for pelvic incidence. Thus, we conclude that anatomical sacral slope can be considered as a helpful anatomical pelvic parameter that is a substitute for pelvic incidence not only in normal healthy subjects, but also in patients with developmental dysplasia of the hip.


2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Norio Imai ◽  
Hayato Suzuki ◽  
Atsushi Sakagami ◽  
Yuki Hirano ◽  
Naoto Endo

Abstract Background The anatomical sacral slope is considered as an anatomical pelvic parameter independent of femoral head centers for measurement of anatomical sacral slope and was previously described to strongly correlate with pelvic incidence on a two-dimensional examination of healthy subjects. However, the correlation between anatomical sacral slope and pelvic incidence was unclear in patients with developmental dysplasia of the hip. This study aimed to examine the correlation between anatomical sacral slope and other spinopelvic parameters by analyzing plain radiographs of female patients with developmental dysplasia of the hip. Methods Eighty-four women with developmental dysplasia of the hip were examined. Lumbar lordosis, thoracic kyphosis, pelvic incidence, sacral slope, and anatomical sacral slope (the angle formed by the straight line of the S1 superior endplate and a line at a right angle to the anterior pelvic plane) were determined by analyzing plain radiographs. The correlations were examined by Pearson’s correlation coefficients, and intra- and inter-rater intraclass correlation coefficients were evaluated for reliability. Results A strong correlation was observed between pelvic incidence and anatomical sacral slope (r = 0.725, p < 0.001). In addition, the correlation between anatomical sacral slope and lumbar lordosis was similar to that between pelvic incidence and lumbar lordosis (r = 0.661, p < 0.001, and r = 0.554, p < 0.001, respectively). The intra-rater intraclass correlation coefficient values were 0.869 and 0.824 for anatomical sacral slope and pelvic incidence, respectively. Furthermore, the inter-rater intraclass correlation coefficient values were 0.83 and 0.685 for anatomical sacral slope and pelvic incidence, respectively. Conclusions We observed that the strong correlation between anatomical sacral slope and pelvic incidence in patients with developmental dysplasia of the hip was equal to that in normal healthy subjects. The correlation between anatomical sacral slope and lumbar lordosis was equal to that between pelvic incidence and lumbar lordosis. Additionally, the intraclass correlation coefficient values for the anatomical sacral slope were slightly higher than those for pelvic incidence. Thus, we conclude that anatomical sacral slope can be considered as a helpful anatomical pelvic parameter that is a substitute for pelvic incidence not only in normal healthy subjects, but also in patients with developmental dysplasia of the hip.


2019 ◽  
Vol 28 (1) ◽  
pp. 230949901988880
Author(s):  
Hayato Suzuki ◽  
Norio Imai ◽  
Asami Nozaki ◽  
Yuki Hirano ◽  
Naoto Endo

Purpose: Anatomical sacral slope (a-SS), a pelvic anatomical parameter that does not require the center of the femoral head, strongly correlates with pelvic incidence (PI) during three-dimensional measurements in normal subjects. Sagittal alignment of spinal and pelvic parameters is typically evaluated using two-dimensional radiographs; however, the relationship between a-SS and PI has not been evaluated using radiographs. This study aimed to evaluate the correlation between a-SS and other spinal and pelvic parameters using radiographs. Methods: We evaluated 144 healthy women. Using sagittal radiographs, we measured lumbar lordosis (LL), thoracic kyphosis, PI, SS, pelvic tilt, and a-SS, which were defined as the angle between the superior end plate of S1 and a line perpendicular to the anterior pelvic plane. Pearson coefficients were used to determine correlations, and intraobserver and interobserver intraclass correlation coefficients (ICCs) were used for validation. Results: There was a strong correlation between PI and a-SS ( r = 0.756). Moreover, correlations between a-SS and LL and between PI and LL were similar ( r = 0.661 and r = 0.554, respectively). The intraobserver ICCs were 0.884 for a-SS and 0.840 for PI. The interobserver ICCs were 0.856 for a-SS and 0.653 for PI. Conclusion: a-SS was strongly correlated with PI. The correlation between a-SS and LL was equivalent to the correlation between PI and LL. Moreover, the ICC for a-SS was larger than that of PI. This study suggests that a-SS is a useful new pelvic anatomical parameter that can be used instead of PI.


Nutrients ◽  
2021 ◽  
Vol 13 (4) ◽  
pp. 1163
Author(s):  
Suzana Shahar ◽  
Mohd Razif Shahril ◽  
Noraidatulakma Abdullah ◽  
Boekhtiar Borhanuddin ◽  
Mohd Arman Kamaruddin ◽  
...  

Measuring dietary intakes in a multi-ethnic and multicultural setting, such as Malaysia, remains a challenge due to its diversity. This study aims to develop and evaluate the relative validity of an interviewer-administered food frequency questionnaire (FFQ) in assessing the habitual dietary exposure of The Malaysian Cohort (TMC) participants. We developed a nutrient database (with 203 items) based on various food consumption tables, and 803 participants were involved in this study. The output of the FFQ was then validated against three-day 24-h dietary recalls (n = 64). We assessed the relative validity and its agreement using various methods, such as Spearman’s correlation, weighed Kappa, intraclass correlation coefficient (ICC), and Bland–Altman analysis. Spearman’s correlation coefficient ranged from 0.24 (vitamin C) to 0.46 (carbohydrate), and almost all nutrients had correlation coefficients above 0.3, except for vitamin C and sodium. Intraclass correlation coefficients ranged from −0.01 (calcium) to 0.59 (carbohydrates), and weighted Kappa exceeded 0.4 for 50% of nutrients. In short, TMC’s FFQ appears to have good relative validity for the assessment of nutrient intake among its participants, as compared to the three-day 24-h dietary recalls. However, estimates for iron, vitamin A, and vitamin C should be interpreted with caution.


Diagnostics ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. 1174
Author(s):  
Si-Wook Lee ◽  
Hee-Uk Ye ◽  
Kyung-Jae Lee ◽  
Woo-Young Jang ◽  
Jong-Ha Lee ◽  
...  

Hip joint ultrasonographic (US) imaging is the golden standard for developmental dysplasia of the hip (DDH) screening. However, the effectiveness of this technique is subject to interoperator and intraobserver variability. Thus, a multi-detection deep learning artificial intelligence (AI)-based computer-aided diagnosis (CAD) system was developed and evaluated. The deep learning model used a two-stage training process to segment the four key anatomical structures and extract their respective key points. In addition, the check angle of the ilium body balancing level was set to evaluate the system’s cognitive ability. Hence, only images with visible key anatomical points and a check angle within ±5° were used in the analysis. Of the original 921 images, 320 (34.7%) were deemed appropriate for screening by both the system and human observer. Moderate agreement (80.9%) was seen in the check angles of the appropriate group (Cohen’s κ = 0.525). Similarly, there was excellent agreement in the intraclass correlation coefficient (ICC) value between the measurers of the alpha angle (ICC = 0.764) and a good agreement in beta angle (ICC = 0.743). The developed system performed similarly to experienced medical experts; thus, it could further aid the effectiveness and speed of DDH diagnosis.


Gerontology ◽  
2017 ◽  
Vol 64 (4) ◽  
pp. 401-412 ◽  
Author(s):  
Hans Drenth ◽  
Sytse U. Zuidema ◽  
Wim P. Krijnen ◽  
Ivan Bautmans ◽  
Cees van der Schans ◽  
...  

Background: Paratonia is a distinctive form of hypertonia, causing loss of functional mobility in early stages of dementia to severe high muscle tone and pain in the late stages. For assessing and evaluating therapeutic interventions, objective instruments are required. Objective: Determine the psychometric properties of the MyotonPRO, a portable device that objectively measures muscle properties, in dementia patients with paratonia. Methods: Muscle properties were assessed with the MyotonPRO by 2 assessors within one session and repeated by the main researcher after 30 min and again after 6 months. Receiver operating characteristic curves were constructed for all MyotonPRO outcomes to discriminate between participants with (n = 70) and without paratonia (n = 82). In the participants with paratonia, correlation coefficients were established between the MyotonPRO outcomes and the Modified Ashworth Scale for paratonia (MAS-P) and muscle palpation. In participants with paratonia, reliability (intraclass correlation coefficient) and agreement values (standard error of measurement and minimal detectable change) were established. Longitudinal outcome from participants with paratonia throughout the study (n = 48) was used to establish the sensitivity for change (correlation coefficient) and responsiveness (minimal clinical important difference). Results: Included were 152 participants with dementia (mean [standard deviation] age of 83.5 [98.2]). The area under the curve ranged from 0.60 to 0.67 indicating the MyotonPRO is able to differentiate between participants with and without paratonia. The MyotonPRO explained 10-18% of the MAS-P score and 8-14% of the palpation score. Interclass correlation coefficients for interrater reliability ranged from 0.57 to 0.75 and from 0.54 to 0.71 for intrarater. The best agreement values were found for tone, elasticity, and stiffness. The change between baseline and 6 months in the MyotonPRO outcomes explained 8-13% of the change in the MAS-P scores. The minimal clinically important difference values were all smaller than the measurement error. Conclusion: The MyotonPRO is potentially applicable for cross-sectional studies between groups of paratonia patients and appears less suitable to measure intraindividual changes in paratonia. Because of the inherent variability in movement resistance in paratonia, the outcomes from the MyotonPRO should be interpreted with care; therefore, future research should focus on additional guidelines to increase the clinical interpretation and improving reproducibility.


2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Yasuhito Takahashi ◽  
Kei Watanabe ◽  
Masashi Okamoto ◽  
Shun Hatsushikano ◽  
Kazuhiro Hasegawa ◽  
...  

Abstract Background Although pelvic incidence (PI) is a key morphologic parameter in assessing spinopelvic sagittal alignment, accurate measurements of PI become difficult in patients with severe hip dislocation or femoral head deformities. This study aimed to investigate the reliability of our novel morphologic parameters and the correlations with established sagittal spinopelvic parameters. Methods One hundred healthy volunteers (25 male and 75 female), with an average age of 38.9 years, were analysed. Whole-body alignment in the standing position was measured using a slot-scanning X-ray imager. We measured the established spinopelvic sagittal parameters and a novel parameter: the sacral incidence to pubis (SIP). The correlation coefficient of each parameter, regression equation of PI using SIP, and regression equation of lumbar lordosis (LL) using PI or SIP were obtained. The intraclass correlation coefficient (ICC) was calculated as an evaluation of the measurement reliability. Results Reliability analysis showed high intra- and inter-rater agreements in all the spinopelvic parameters, with ICCs > 0.9. The SIP and pelvic inclination angle (PIA) demonstrated strong correlation with PI (R = 0.96) and pelvic tilt (PT) (R = 0.92). PI could be predicted according to the regression equation: PI = − 9.92 + 0.905 * SIP (R = 0.9596, p < 0.0001). The ideal LL could be predicted using the following equation using PI and age: ideal LL = 32.33 + 0.623 * PI – 0.280 * age (R = 0.6033, p < 0.001) and using SIP and age: ideal LL = 24.29 + 0.609 * SIP – 0.309 * age (R = 0.6177, p < 0.001). Conclusions Both SIP and PIA were reliable parameters for determining the morphology and orientation of the pelvis, respectively. Ideal LL was accurately predicted using the SIP with equal accuracy as the PI. Our findings will assist clinicians in the assessment of spinopelvic sagittal alignment. Trial registration This study was retrospectively registered with the UMIN Clinical Trials Registry (UMIN000042979; January 13, 2021).


2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1423.2-1424
Author(s):  
J. A. Mendonça ◽  
I. Siste de Almeida Aoki ◽  
C. C. Cavuto ◽  
V. A. Leandro-Merhi ◽  
J. L. B. D. Aquino

Background:The gray scale (GS) in high resolution ultrasound is already well validated for use in rheumatological diseases, but the color map or the histogram, can be considered a new proposal, to better define and complement the echotextural damages detection1.Objectives:To calculate the lesions area measures reproducibility index in arthropathies, between 3 blind evaluators and correlate these measures using the GS and the histogram.Methods:Observational and retrospective study approved by the ethics committee of the Pontifical Catholic University of Campinas, with the opinion number: 1.526.307. A total of 29 patients have been assessed (31% males and 69% females) on period 2014 to 2019 in Rheumatology service. A MyLab 50 -Esaote equipment was used with frequency transducer that ranged between 6.0 and 18.0 MHz, 10 different area measures were performed from each recorded images previously, by the GS and the histogram. Statistical analysis: Spearman’s correlation coefficients, Lin’s concordance coefficient (CCC) and the intraclass correlation coefficient (ICC) and their respective 95% confidence intervals, with the SPSS software package for Windows v. 17.0 (SPSS Inc., Chicago, IL, USA).Results:Average age 43.5 ± 21.5 years of age; with disease duration that varied between ≤ 1 month (48.3%) and ≥36 months (24.1%); with the following diseases: juvenile idiopathic arthritis (17.24%); osteoarthritis (13.79%); psoriatic arthritis (13.79%); undifferentiated spondyloarthritis (3.44%); gout (20.68%); rheumatoid arthritis (27.58%) and reactive arthritis (3.44%). A total of 840 measures of exudative (27.58%), proliferative (27.58%) and snowstorm appearance (6.89%) synovitis were performed; femoral-condyle cartilage (3.44%); synovial cyst (3.44%); paratendinitis (6.89%); calcification (3.44%); nail enthesitis (3.44%); tenosynovitis (6.89%) and tophi (10.34%) (Figure 1). The concordance correlation coefficient showed values closer to 1; p <0.001, the intraclass correlation coefficients with excellent reproducibility (ICC ≥ 0.75); p <0.001, always in relation to the three evaluators (Table 1) and the Spearman correlation between the GS and the histogram ranged from rs = 0.665 to rs = 1,000; p <0.001.Conclusion:The histogram can be considered an image method to better identify echotextural damages.References:[1]Mendonça J, Provenza J, Guissa V, et al AB1059 2D Histogram Ultrasound and 3D Ultrasound Correlation in Rheumatic Diseases Annals of the Rheumatic Diseases 2015; 74:1253-1254.Table 1.Concordance Correlation Coefficient (CCC) and Intraclass Correlation Coefficient (ICC):EvaluatorsGS - CCC(IC 95%)p-valorHistogram (IC 95%)p-valor1 e 20,998(0,994-0,999)<0,0010,999(0,995-1,000)<0,0011 e 30,998(0,995-0,999)<0,0010,999(0,995-1,000)<0,0012 e 30,992(0,980-0,997)<0,010,996(0,979-0,999)<0,01Standard by US 2DICCp-valorGS0,997(0,992-0,999)<0,001Histogram0,998(0,992-0,999)<0,001Legends: Gray Scale (GS).Figure 1.Patient with gout: A and B: Tophi area measures (star) in right metatarsos and efusion (arrow) by GS (45 mm2) and histogram (39 mm2), respectively.Disclosure of Interests:José Alexandre Mendonça Speakers bureau: Novartis, Janssen, Bristol, UCB, Isabella Siste de Almeida Aoki: None declared, Caique Chagas Cavuto: None declared, Vânia Aparecida Leandro-Merhi: None declared, José Luis Braga de Aquino: None declared


2021 ◽  
Vol 8 ◽  
Author(s):  
Yunru Liao ◽  
Zhenlan Yang ◽  
Zijing Li ◽  
Rui Zeng ◽  
Jing Wang ◽  
...  

Purpose: Purpose of this study is to evaluate the measuring consistency of central refraction between multispectral refraction topography (MRT) and autorefractometry.Methods: This was a descriptive cross-sectional study including subjects in Sun Yat-sen Memorial Hospital from September 1, 2020, to December 31, 2020, ages 20 to 35 years with a best corrected visual acuity of 20/20 or better. All patients underwent cycloplegia, and the refractive status was estimated with autorefractometer, experienced optometrist and MRT. We analyzed the central refraction of the autorefractometer and MRT. The repeatability and reproducibility of values measured using both devices were evaluated using intraclass correlation coefficients (ICCs).Results: A total of 145 subjects ages 20 to 35 (290 eyes) were enrolled. The mean central refraction of the autorefractometer was −4.69 ± 2.64 diopters (D) (range −9.50 to +4.75 D), while the mean central refraction of MRT was −4.49 ± 2.61 diopters (D) (range −8.79 to +5.02 D). Pearson correlation analysis revealed a high correlation between the two devices. The intraclass correlation coefficient (ICC) also showed high agreement. The intrarater and interrater ICC values of central refraction were more than 0.90 in both devices and conditions. At the same time, the mean central refraction of experienced optometrist was −4.74 ± 2.66 diopters (D) (range −9.50 to +4.75D). The intra-class correlation coefficient of central refraction measured by MRT and subjective refraction was 0.939.Conclusions: Results revealed that autorefractometry, experienced optometrist and MRT show high agreement in measuring central refraction. MRT could provide a potential objective method to assess peripheral refraction.


1999 ◽  
Vol 8 (4) ◽  
pp. 254-261 ◽  
Author(s):  
J Powers ◽  
SJ Bennett

BACKGROUND: Dyspnea, or difficult breathing, is common in patients receiving mechanical ventilation; however, dyspnea is not routinely or systematically measured. OBJECTIVE: The primary purpose of this methodological study was to evaluate the test-retest reliability of 5 dyspnea rating scales and the criterion validity of 4 dyspnea rating scales in patients receiving mechanical ventilation. The secondary purpose was to examine the correlations between each of these 5 rating scales and physiological measures of respiratory function. METHODS: The convenience sample consisted of 28 patients on mechanical ventilation during their hospitalization in the intensive care units of a large, inner-city hospital. Patients rated their dyspnea twice at 30-minute intervals on the visual analogue scale, the vertical analogue dyspnea scale, the modified Borg scale, the numerical scale, and the faces scale. Test-retest reliability was computed by using the intraclass correlation coefficient. Criterion validity was evaluated by using the Spearman rank-order correlation coefficient. RESULTS: The 5 rating scales had acceptable test-retest reliabilities, with intraclass correlation coefficients ranging from 0.81 to 0.97. Criterion validity of the 4 scales also was acceptable, with Spearman rank-order correlation coefficients from 0.76 to 0.96. The rating scales were not correlated with most of the physiological variables. At least half of the patients reported moderate to severe dyspnea. CONCLUSION: The scales showed acceptable reliability and validity, and they will be useful in quantifying dyspnea experienced by patients receiving mechanical ventilation. Further work is needed to evaluate the extent and the severity of dyspnea in such patients in order to evaluate the effectiveness of interventions.


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