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Assessment of Acetabular Morphology Using the Acetabular Anterior Center-Edge Angle on Modified False-Profile Radiographs

      Purpose

      To compare radiographic parameters of acetabular morphology between standard and modified false-profile (FP) radiographs.

      Methods

      Standard and modified FP radiographs were obtained in 225 hips in 200 consecutive patients evaluated for hip pain and suspected femoroacetabular impingement. Radiographs were retrospectively reviewed by 2 readers to determine the anterior center-edge angle (ACEA), as assessed to the sourcil and to the bone edge. Inter-rater reliability of radiographic measurements was assessed using the intraclass correlation coefficient. Measurements were evaluated for normality with the Shapiro-Wilk test, averaged between the 2 readers, and compared between views using the paired Wilcoxon test.

      Results

      The intraclass correlation coefficient values for standard and modified FP views were 0.923 and 0.932, respectively, measuring to the sourcil and 0.867 and 0.896, respectively, measuring to the lateral bone edge. The median difference in ACEA measurements to the sourcil was 1° between the standard and modified FP view (45° vs 44°, P < .001). The median difference in ACEA measurements to the bone edge was 2° (34° vs 32°, P < .001).

      Conclusions

      Thirty-five degrees of femoral internal rotation for a modified FP hip radiographic view provides similar clinical information regarding acetabular morphology to that of the standard FP view. Given that the modified FP view also provides better visualization of the anterosuperior head-neck junction cam lesion, the modified FP view may be preferred over the standard FP view in evaluation of hip pain in the young patient.

      Level of Evidence

      Level III, retrospective comparative study.
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      Linked Article

      • Editorial Commentary: Modified False-Profile View—Two Birds With One Stone?
        ArthroscopyVol. 35Issue 11
        • Preview
          Pathology in the hip is most commonly described using radiographic parameters. Accurately delineating this pathology is paramount in proper diagnosis and care. The anterior center-edge angle measures the anterior coverage of the acetabulum, which has implications in treating the hip. The modified false-profile view will allow visualization of not only the anterior coverage of the femoral head but also the patient's alpha angle. As such, the modified false-profile view could replace both the standard false-profile view and the 45° Dunn view, essentially reducing by 1 the number of images required to evaluate patients presenting with hip symptoms.
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