The Ischial Spine Sign: Does Pelvic Tilt and Rotation Matter?

Although the ischial spine sign (ISS) has been advocated to detect acetabular retroversion, it is unknown whether the sign is valid on anteroposterior (AP) pelvic radiographs with tilted or rotated pelves. We therefore evaluated reliability of the ISS as a tool for diagnosing acetabular retroversion...

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Bibliographic Details
Published in:Clinical orthopaedics and related research 2010-03, Vol.468 (3), p.769-774
Main Authors: Kakaty, Diganta K., Fischer, Andreas F., Hosalkar, Harish S., Siebenrock, Klaus A., Tannast, Moritz
Format: Article
Language:English
Subjects:
Acetabulum - diagnostic imaging
Acetabulum - pathology
Adolescent
Adult
Biological and medical sciences
Cadaver
Clinical Research
Conservative Orthopedics
Diseases of the osteoarticular system
Female
Hip Dislocation - diagnostic imaging
Hip Dislocation - pathology
Hip Joint - diagnostic imaging
Hip Joint - pathology
Humans
Ischium - diagnostic imaging
Ischium - pathology
Male
Medical sciences
Medicine
Medicine & Public Health
Middle Aged
Orthopedics
Posture
Predictive Value of Tests
Radiography
Reproducibility of Results
Retrospective Studies
Rotation
Sports Medicine
Surgery
Surgical Orthopedics
Torsion Abnormality - diagnosis
Young Adult
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Summary:Although the ischial spine sign (ISS) has been advocated to detect acetabular retroversion, it is unknown whether the sign is valid on anteroposterior (AP) pelvic radiographs with tilted or rotated pelves. We therefore evaluated reliability of the ISS as a tool for diagnosing acetabular retroversion in the presence of considerable pelvic tilt and/or malrotation. We obtained radiographs of 20 cadaver pelves in 19 different malorientations resulting in 380 pelvis images (760 hips) for evaluation. In addition, 129 clinical radiographs of patients’ hips that had varying pelvis orientations were reviewed. We found an overall sensitivity of 81% (90%), specificity of 70% (71%), positive predictive value of 77% (80.7%), and negative predictive value of 75% (85%) in the cadaver (patient) hips. Our data suggest the ISS is a valid tool for diagnosing acetabular retroversion on plain radiographs taken using a standardized technique regardless of the degree of pelvic tilt and rotation.
ISSN:0009-921X
1528-1132
DOI:10.1007/s11999-009-1021-5