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Femoral and tibial torsion measurement in children and adolescents: comparison of 3D models based on low-dose biplanar radiography and low-dose CT


Rosskopf, Andrea B; Ramseier, Leonhard E; Sutter, Reto; Pfirrmann, Christian W A; Buck, Florian M (2014). Femoral and tibial torsion measurement in children and adolescents: comparison of 3D models based on low-dose biplanar radiography and low-dose CT. American Journal of Roentgenology, 202(3):W285-W291.

Abstract

OBJECTIVE The purpose of this study was to evaluate the interchangeability and reliability of femoral and tibial torsion measurements in children using 3D models based on biplanar radiography compared with CT measurements. MATERIALS AND METHODS Femoral and tibial torsion were measured in 50 patients (mean age, 10.9 years; range, 4.7-14.8 years) using 3D models based on low-dose biplanar radiography by two independent readers. Measurements on transverse CT images by two independent readers served as the reference standard. Intermethod and interreader agreement was calculated using descriptive statistics, intraclass correlation coefficient (ICC), and Bland-Altman analysis. RESULTS Femoral and tibial torsion were -6°-65° and 6°-51° for 3D models based on biplanar radiography and -13°-59° and 4°-52° for CT measurements. The average difference (±SD) between the two methods was 4.9°±3.8° and 5.5°±4.1°, respectively. The intermethod ICC for biplanar radiography was 0.90 (95% CI, 0.87-0.92) for femoral torsion and 0.75 (0.68-0.80) for tibial torsion. The interreader ICC was 0.93-0.97. Mean measurement differences between the two biplanar radiography readers were 3.4° (0.0°-11.0°) for femoral torsion and 3.9° (0.0°-15.0°) for tibial torsion. Mean interreader differences at CT were 3.3° (0.0°-9.0°) for femoral and 3.0° (0.0°-10.0°) for tibial torsion. There was no trend for larger intermethod differences with decreasing age of the children. CONCLUSION Femoral and tibial torsion measurements in children using 3D models based on biplanar radiography are comparable to CT measurement results. Despite skeletal immaturity, torsion measurements in children on biplanar radiography seem to be as reliable as those on CT images.

Abstract

OBJECTIVE The purpose of this study was to evaluate the interchangeability and reliability of femoral and tibial torsion measurements in children using 3D models based on biplanar radiography compared with CT measurements. MATERIALS AND METHODS Femoral and tibial torsion were measured in 50 patients (mean age, 10.9 years; range, 4.7-14.8 years) using 3D models based on low-dose biplanar radiography by two independent readers. Measurements on transverse CT images by two independent readers served as the reference standard. Intermethod and interreader agreement was calculated using descriptive statistics, intraclass correlation coefficient (ICC), and Bland-Altman analysis. RESULTS Femoral and tibial torsion were -6°-65° and 6°-51° for 3D models based on biplanar radiography and -13°-59° and 4°-52° for CT measurements. The average difference (±SD) between the two methods was 4.9°±3.8° and 5.5°±4.1°, respectively. The intermethod ICC for biplanar radiography was 0.90 (95% CI, 0.87-0.92) for femoral torsion and 0.75 (0.68-0.80) for tibial torsion. The interreader ICC was 0.93-0.97. Mean measurement differences between the two biplanar radiography readers were 3.4° (0.0°-11.0°) for femoral torsion and 3.9° (0.0°-15.0°) for tibial torsion. Mean interreader differences at CT were 3.3° (0.0°-9.0°) for femoral and 3.0° (0.0°-10.0°) for tibial torsion. There was no trend for larger intermethod differences with decreasing age of the children. CONCLUSION Femoral and tibial torsion measurements in children using 3D models based on biplanar radiography are comparable to CT measurement results. Despite skeletal immaturity, torsion measurements in children on biplanar radiography seem to be as reliable as those on CT images.

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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > Balgrist University Hospital, Swiss Spinal Cord Injury Center
04 Faculty of Medicine > University Children's Hospital Zurich > Clinic for Surgery
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:March 2014
Deposited On:16 Jan 2015 13:59
Last Modified:05 Apr 2016 18:48
Publisher:American Roentgen Ray Society
ISSN:0361-803X
Publisher DOI:https://doi.org/10.2214/AJR.13.11103
PubMed ID:24555627

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