Hellfritzsch, Michel Bach

Henriksen, Mads

Husum, Hans-Christen

Klitt Jensen, Christian

Rahbek, Ole

Introduction and Objective: Ultrasound screening fordevelopmental dysplasia of the hip (DDH) is conventionallybased upon the method developed by Graf. In 2013 thepubo femoral distance (PFD) was proposed as a new ultrasoundscreening measurement, defined as the minimallymeasurable distance between the medial aspect of the femoralhead and the pubic bone, but no consensus exists onthe positioning of the child when performing the examination.Our aim is to examine the agreement of PFD whenmeasured with the child in the lateral versus supineposition.Materials and Methods: We included a consecutiveseries of children referred for hip ultrasound suspect forDDH during a period of two months. The PFD measurementwas obtained for each child for both hips, afterwardsthe child was placed in the supine position and the PFDmeasurement was repeated on both sides. Ultrasoundexaminations were performed by two experienced pediatricmusculoskeletal radiologists. Mean PFD values for lateraland supine positioning were compared using Student’spaired t-test and controlled for age of the child using linearregression. Agreement was analyzed using Bland Altmanplot.Results: We included 30 children (15 boys), mean age atexamination was 34 days (range 13-83). Mean PFD in lateralposition was 3.5 mm 95%CI (3.2; 3.7) and did notdiffer significantly from mean PFD in supine position at3.6 95%CI (3.4; 3.9). Mean difference in PFD betweenexamination positions was 0.16 mm 95%CI (-0.31; 0.58)and was not significantly correlated to the child’s age atexamination (p = 0.062). Inspection of the Bland Altmanplot did not reveal a systematic difference in PFD betweenexamination positions.Conclusions: Shifting from lateral to supine examinationposition of the child had no impact on PFD measurements.These findings underline the versatility of the PFD measurementas a screening tool for DDH.<br/

Comparison of pubo femoral distances in lateral versus supine positioning of the child

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