Confiabilidad de una nueva clasificación radiográfica para la displasia de desarrollo de la cadera / Reliability of a New Radiographic Classification for Developmental Dysplasia of the Hip

#displasiadedesarrollodelacadera #DevelopmentalDysplasiaoftheHip

Este artículo es originalmente publicado en:
Narayanan U1, Mulpuri K, Sankar WN, Clarke NM, Hosalkar H, Price CT; International Hip Dysplasia Institute Study Group.
J Pediatr Orthop. 2014 Sep 26. [Epub ahead of print]
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 Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved.



Existing radiographic classification schemes (eg, Tönnis criteria) for DDH quantify the severity of disease based on the position of the ossific nucleus relative to Hilgenreiner’s and Perkin’s lines. By definition, this method requires the presence of an ossification centre, which can be delayed in appearance and eccentric in location within the femoral head. A new radiographic classification system has been developed by the International Hip Dysplasia Institute (IHDI), which uses the mid-point of the proximal femoral metaphysis as a reference landmark, and can therefore be applied to children of all ages. The purpose of this study was to compare the reliability of this new method with that of Tönnis, as the first step in establishing its validity and clinical utility.


The IHDI method of classification has excellent inter-rater reliability, both among experts and novices, and is more widely applicable than the Tönnis method as it can be applied even when the ossification centre is absent.
 Los esquemas de clasificación radiográficos
existentes (por ejemplo, criterios Tönnis) para DDH cuantificar la gravedad de la enfermedad basándose en la posición del núcleo de osificación en relación con Hilgenreiner de líneas y de Perkin. Por definición, este método requiere la presencia de un centro de osificación, que puede ser retrasada en apariencia y excéntrico en una ubicación dentro de la cabeza femoral. Un nuevo sistema de clasificación radiográfica ha sido desarrollado por el Hip Internacional Displasia Instituto (IDH-D), que utiliza el punto medio de la metáfisis femoral proximal como un hito de referencia, y por lo tanto se puede aplicar a los niños de todas las edades. El propósito de este estudio fue comparar la fiabilidad de este nuevo método con el de Tönnis, como el primer paso para establecer su validez y utilidad clínica. 
Conclusiones :
El método IDH-D de clasificación tiene una excelente fiabilidad entre evaluadores, tanto entre expertos y novatos, y es más ampliamente aplicable que el método Tönnis ya que puede aplicarse incluso cuando el centro de osificación está ausente.





Level II (diagnostic).

This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivitives 3.0 License, where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially.




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#displasiadedesarrollodelacadera #DevelopmentalDysplasiaoftheHip

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