Anteroposterior pelvic radiographs to assess acetabular retroversion: High validity of the "cross-over-sign"

Acetabular retroversion has been proposed to contribute to the development of osteoarthritis of the hip. For the diagnosis of this condition, conventional AP pelvic radiographs may represent a reliable, easily available diagnostic modality as they can be obtained with a reproducible technique allowi...

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Bibliographic Details
Published in:Journal of orthopaedic research 2007-06, Vol.25 (6), p.758-765
Main Authors: Jamali, Amir A., Mladenov, Kiril, Meyer, Dominik C., Martinez, Alberto, Beck, Martin, Ganz, Reinhold, Leunig, Michael
Format: Article
Language:English
Subjects:
Acetabulum - abnormalities
Acetabulum - diagnostic imaging
Adolescent
Adult
Aged
Arthrography - standards
Female
femoroacetabular impingement
Femur Head - diagnostic imaging
hip
Hip Joint - abnormalities
Hip Joint - diagnostic imaging
Humans
Male
Middle Aged
osteoarthritis
Osteoarthritis, Hip - diagnostic imaging
Pelvis - diagnostic imaging
radiograph
Reproducibility of Results
retroversion
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Summary:Acetabular retroversion has been proposed to contribute to the development of osteoarthritis of the hip. For the diagnosis of this condition, conventional AP pelvic radiographs may represent a reliable, easily available diagnostic modality as they can be obtained with a reproducible technique allowing the anterior and posterior acetabular rims to be visible for assessment. This study was designed to: (i) determine cranial, central, and caudal anatomic acetabular version (AV) from cadaveric specimens; (ii) establish the validity and reliability of the radiographic measurements of central acetabular anteversion; and (iii) determine the validity and reliability of the radiographic “cross‐over‐sign” to detect acetabular retroversion. Using 43 desiccated pelvises (86 acetabuli) the anatomic AVs were measured at three different transverse planes (cranially, centrally, and caudally). From these pelvises, standardized AP pelvic radiographs were obtained. To directly measure central AV, a modified radiographic method is introduced for the use of AP pelvic radiographs. The validity and reliability of this radiographic method and of the radiographic cross‐over‐sign to detect cranial acetabular retroversion were determined. The mean central and caudal anatomic AVs were approximately 20°, and the mean cranial AV was 8°. Cranial retroversion (AV 
ISSN:0736-0266
1554-527X
DOI:10.1002/jor.20380