Measurement of Neck-Shaft Angle Using CT Scout View in Healthy Jordanian Adults - A Reliability and Agreement Study

Main Article Content

Ibrahim Altubasi
Hayat Hamzeh
Mohammad Madi

Abstract

Aims: To report estimates of the reliability and agreement of a new method for measuring the femoral Neck-shaft angle in the Jordanian population. The neck-shaft angle is an important anatomical indicator in orthopedics of the hip. While there are different approaches to measuring the neck-shaft angle in the literature, there is no agreement on the best technique used for measurement. CT scout view was used in this study to provide a promising alternative.

Study Design: Observational reliability and agreement study.

Places and Duration of the Study: Department of physiotherapy, school of rehabilitation science, University of Jordan and University of Jordan Hospital between March 2014 and October 2015.

Methodology: Two independent raters calculated the neck-shaft angle on each hip of 50 pelvic CT scout images of healthy adults to determine inter-rater reliability. One rater performed the measurement twice to determine the intra-rater reliability. Intra-class correlation coefficients were used to examine relative reliability. The standard error of measurement (SEM) and 95% minimal detectable change (MDC) were calculated to examine absolute reliability. 

Results: The mean value of all angle measurements was 131.3. Intra-class correlation coefficients were 0.726 and 0.63 for inter and intra-rater measurements respectively. SEM and MDC for inter-rater measurements were 2.69 and 7.46 respectively. For intra-rater measurements, they were 2.84 and 7.86 respectively.

Conclusion: The new method proposed in this study for measuring the neck-shaft angle showed good reliability and small measurement error.

Keywords:
Neck-shaft angle, reliability, CT scout images, standard error of measurement, minimal detectable change.

Article Details

How to Cite
Altubasi, I., Hamzeh, H., & Madi, M. (2020). Measurement of Neck-Shaft Angle Using CT Scout View in Healthy Jordanian Adults - A Reliability and Agreement Study. Journal of Advances in Medicine and Medical Research, 32(16), 9-17. https://doi.org/10.9734/jammr/2020/v32i1630624
Section
Original Research Article

References

Gilligan I, Chandraphak S, Mahakkanukrauh P. Femoral neck-shaft angle in humans: Variation relating to climate, clothing, lifestyle, sex, age and side. J Anat. 2013;223(2):133-51.

Hermanson M, Hagglund G, Riad J, Wagner P. Head-shaft angle is a risk factor for hip displacement in children with cerebral palsy. Acta Orthop. 2015;86(2): 229-32.

Lecerf G, Fessy MH, Philippot R, Massin P, Giraud F, Flecher X, et al. Femoral offset: Anatomical concept, definition, assessment, implications for preoperative templating and hip arthroplasty. Orthop Traumatol-Sur. 2009;95(3):210-9.

Gnudi S, Sitta E, Pignotti E. Prediction of incident hip fracture by femoral neck bone mineral density and neck–shaft angle: a 5-year longitudinal study in post-menopausal females. Brit J Radiol. 2012;85(1016): e467-e73.

Szulc P. Bone density, geometry, and fracture in elderly men. Curr Osteoporos Rep. 2006;4(2):57-63.

Hadidy AM, Abu-Labn DM, Ahmad TM, Haroun AA, Al-Hadidi MT, Mahafza WS, et al. Hip magnetic resonance imaging: descriptive epidemiology and outcome in Jordan University Hospital. Jordan Med J. 2010;44(2):144-51.

Boese CK, Dargel, J., Oppermann, J., Eysel, P., Scheyerer, M. J., Bredow, J., & Lechler P. The femoral neck-shaft angle on plain radiographs: a systematic review. Skeletal Radiol. 2016;45(1):19-28.

Wilson JD, Eardley W, Odak S, Jennings A. To what degree is digital imaging reliable? Validation of femoral neck shaft angle measurement in the era of picture archiving and communication systems. Brit J Radiol. 2011;84(1000):375-9.

Pons C, Rémy-Néris O, Médée B, Brochard S. Validity and reliability of radiological methods to assess proximal hip geometry in children with cerebral palsy: a systematic review. Dev Med Child Neurol. 2013;55(12):1089-102.

Boese CK, Frink M, Jostmeier J, Haneder S, Dargel J, Eysel P, et al. The Modified Femoral Neck-Shaft Angle: Age- and Sex-Dependent Reference Values and Reliability Analysis. BioMed Res Int. 2016; 2016:7.

Boese CK, Jostmeier J, Oppermann J, Dargel J, Chang D-H, Eysel P, et al. The neck shaft angle: CT reference values of 800 adult hips. Skeletal Radiol. 2016;45(4): 455-63.

Beebe MJ, Wylie JD, Bodine BG, Kapron AL, Maak TG, Mei-Dan O, et al. Accuracy and Reliability of Computed Tomography and Magnetic Resonance Imaging Compared With True Anatomic Femoral Version. J pediat orthoped. 2017;37(4): e265-e70.

Thrall JH. Radiation Exposure in CT Scanning and Risk: Where Are We? Radiology. 2012;264(2):325-8.

Albert JM. Radiation Risk From CT: Implications for Cancer Screening. Am J Roentg. 2013;201(1):W81-W7.

Patel AA, Maver DW, Siegel E. The CT Scout Exam: A survey of radiation dose, utilization, and opportunity for substantial dose reduction. Radiological Society of North America 2010 Scientific Assembly and Annual Meeting; Chicago IL; 2010.

Johnson PT, Scott WW, Gayler BW, Lewin JS, Fishman EK. The CT scout view: does it need to be routinely reviewed as part of the CT interpretation? AJR Am J Roentg. 2014;202(6):1256-63.

Brook O, Guralnik L, Engel A. CT scout view as an essential part of CT reading. Australas Radiol. 2007;51(3):211-7.

Burghardt RD, Hinterwimmer S, Burklein D, Baumgart R. Lower limb alignment in the frontal plane: Analysis from long standing radiographs and computer tomography scout views: an experimental study. Arch orthop traum su. 2013;133(1): 29-36.

Available:http://www.tomovision.com/products/sliceomatic.html

Kottner J, Audige L, Brorson S, Donner A, Gajewski BJ, Hrobjartsson A, et al. Guidelines for Reporting Reliability and Agreement Studies (GRRAS) were proposed. J clin epidemiol. 2011;64(1): 96-106.

Weir J. Quantifying test-retest reliability using the intraclass correlation coefficient and the SEM. J Strength Cond Res. 2005; 19:231-40.

Atkinson G, Nevill AM. Statistical methods for assessing measurement error (reliability) in variables relevant to sports medicine. Sports med.1998;26(4):217-38.

Doherty M, Courtney P, Doherty S, Jenkins W, Maciewicz RA, Muir K, et al. Nonspherical femoral head shape (pistol grip deformity), neck shaft angle, and risk of hip osteoarthritis: A case–control study. Arthritis Rheum. 2008;58(10):3172-82.

Adekoya-Cole T, Akinmokun O, Soyebi K, Oguche O. Femoral neck shaft angles: A radiological anthropometry study. Nigerian Med J. 2016;23(1):17-20.

Jiang N, Peng L, Al-Qwbani M, Xie G-P, Yang Q-M, Chai Y, et al. Femoral version, neck-shaft angle, and acetabular anteversion in Chinese Han population: a retrospective analysis of 466 healthy adults. Medicine. 2015;94(21):e891-e.

Alonso GC, Curiel DM, Carranza HF, Cano PR, Perez DA. femoral bone mineral density, neck-shaft angle and mean femoral neck width as predictors of hip fracture in men and women. Osteoporosis int. 2000;11(8):714-20.

Mahaisavariya B, Sitthiseripratip K, Tongdee T, Bohez ELJ, Vander Sloten J, Oris P. Morphological study of the proximal femur: a new method of geometrical assessment using 3-dimensional reverse engineering. Med Eng Phys. 2002;24(9): 617-22.

Toogood PA, Skalak A, Cooperman DR. Proximal femoral anatomy in the normal human population. Clinl Orthop Relat R. 2008;467(4):876.

Unnanuntana A, Toogood P, Hart D, Cooperman D, Grant RE. Evaluation of proximal femoral geometry using digital photographs. J Orthop Res. 2010;28(11): 1399-404.

Kim S-C, Lim Y-W, Kwon S-Y, Lee J-K, Park I-K, Kim Y-S. Comparative analysis of radiographic hip joint geometry using measurement tools on picture archiving and communication system: A prospective study of 100 pelvic radiographs of Koreans. J Arthroplasty. 2016;31(11): 2597-602.

Guenoun B, Zadegan F, Aim F, Hannouche D, Nizard R. Reliability of a new method for lower-extremity measurements based on stereoradio-graphic three-dimensional reconstruction. Orthop Traumatol-Sur. 2012;98(5):506-13.

Mast NH, Impellizzeri F, Keller S, Leunig M. Reliability and agreement of measures used in radiographic evaluation of the adult hip. Clinl Orthop Relat R. 2011;469(1):188-99.