Summary of - Reliability of 3 Radiologic Classifications for the Severity of the Developmental Dysplasia of the Hip in Children Older Than 4 Years
Document Type
Article
Abstract
Background: Tonnis, International Hip Dysplasia Institute (IHDI), and lateral metaphyseal height (LMH) are commonly used classifications for grading the severity of developmental dysplasia of the hip. However, their reliability in older children has not been widely studied. This study aimed to evaluate the reliability of these three radiologic classifications in children older than 4 years, compare them with children younger than 4 years, and assess cases with varied inter-rater reliability.
Methods: A targeted sample of 40 children, aged 6 months to 8 years, with untreated developmental dysplasia of the hip was examined to assess severity using three different classification systems. Six pediatric orthopedic surgeons evaluated all hips according to the original descriptions of these classifications. Inter-rater and intra-rater reliability were determined using the intraclass correlation coefficient. Cases with differing ratings were thoroughly analyzed to understand the reasons behind the variations.
Results: The interobserver and intraobserver reliability for all three classifications were excellent, with intraclass correlation coefficients (ICC) of 0.935 for IHDI, 0.820 for Tonnis, and 0.935 for LMH classification. This high reliability was consistent across both younger and older children. For dysplastic hips (52 hips), the interobserver reliability was good for Tonnis (ICC: 0.741) and excellent for both IHDI (ICC: 0.911) and LMH classification (ICC: 0.9). The primary reason for the varied ratings was the differing perceptions of the superolateral margin of the acetabulum in some hips.
Conclusion: The inter-rater and intra-rater reliability of the IHDI, Tonnis, and LMH classifications is excellent. These classifications are applicable for children up to 8 years old. A significant cause of inter-rater variability is the challenge in identifying the superolateral margin of the acetabulum.
Publication Date
2022
Recommended Citation
KA, Singh; D, Ganjwala; P, Gupta; Kottamttavida I, Vazhayil; M, Varma; and H, Shah, "Summary of - Reliability of 3 Radiologic Classifications for the Severity of the Developmental Dysplasia of the Hip in Children Older Than 4 Years" (2022). Open Access archive. 9346.
https://impressions.manipal.edu/open-access-archive/9346
