Is the evaluation of the anterior inferior iliac spine (AIIS) in the AP pelvis possible? Analysis of conventional X-rays and 3D-CT reconstructions.

Autor: Krueger DR; Center for Musculoskeletal Surgery, Campus Virchow-Klinikum, Charité - Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany., Windler M; Center for Musculoskeletal Surgery, Campus Virchow-Klinikum, Charité - Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany., Geßlein M; Department of Trauma and Orthopaedic Surgery, Paracelsus Medical University, Nuremberg Hospital South, Breslauer Straße 201, 90471, Nuremberg, Germany., Schuetz M; Center for Musculoskeletal Surgery, Campus Virchow-Klinikum, Charité - Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany., Perka C; Center for Musculoskeletal Surgery, Campus Virchow-Klinikum, Charité - Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany., Schroeder JH; Center for Musculoskeletal Surgery, Campus Virchow-Klinikum, Charité - Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany. joerg.schroeder@charite.de.
Jazyk: angličtina
Zdroj: Archives of orthopaedic and trauma surgery [Arch Orthop Trauma Surg] 2017 Jul; Vol. 137 (7), pp. 975-980. Date of Electronic Publication: 2017 Apr 21.
DOI: 10.1007/s00402-017-2694-y
Abstrakt: Introduction: A hypertrophic AIIS has been identified as a cause for extraarticular hip impingement and is classified according to Hetsroni using 3D-CT reconstructions. The role of the conventional AP pelvis X-ray, which is the first standard imaging step for the evaluation of hip pain, has not been investigated yet.
Materials and Methods: AP pelvis X-rays and 3D-CT reconstructions of patients were evaluated regarding their morphology of the AIIS. The conventional X-rays were categorized into three groups according to the projection of the AIIS: above (A) or below (B) the acetabular sourcil or even exceeding the anterior acetabular rim (C). They were compared to the morphologic types in the 3D-CT reconstruction (Hetsroni type I-III).
Results: Ninety patients with an equal distribution of type A, B or C projection in the AP pelvis were evaluated and compared to the morphology in the 3D-CT reconstruction. The projection of the AIIS below the acetabular sourcil (B + C) showed only moderate sensitivity (0.76) and specificity (0.64) for a hypertrophic AIIS (Hetsroni type II + III), but if the AIIS exceeds the anterior rim, all cases showed a hypertrophic AIIS in the 3D-CT reconstructions (Hetsroni type II + III).
Conclusions: Distinct differentiation of the AIIS morphology in the AP pelvis is not possible, but the projection of the AIIS below the anterior acetabular rim represented a hypertrophic AIIS in all cases and should, therefore, be critically investigated for a relevant AIIS impingement.
Databáze: MEDLINE
Externí odkaz: