Femoroacetabular impingement: can the alpha angle be estimated?

AJR. American Journal of Roentgenology
Mohamed R NouhJodi Cohen

Abstract

Femoroacetabular impingement is an important entity with well-described radiographic findings. One of the criteria of the cam type of femoroacetabular impingement is femoral head-neck dysplasia, denoted mathematically as the "alpha angle." Several observers have reported that direct measurement of the angle may not be necessary because subjective appraisal may yield similar results. We sought to scientifically determine the accuracy of a subjective assessment, using the calculated angle as the gold standard. At 1.5 T, 50 consecutive patients' hips were evaluated on sets of oblique axial images. Two musculoskeletal radiologists recorded their subjective opinion as to the alpha angle using a confidence scale of 1-5. Direct mathematic measurement of the alpha angle was done by a third independent observer and correlated with the subjective results. Correlations between the subjective and measured angles and interobserver variation were calculated. Statistically, significant variability was seen in the subjective assessment of the alpha angle. When the alpha angle was > 55 degrees, the area under the receiver operating characteristic curve (AUC) was 0.606, indicating that visual assessment is a poor predictor of a wide alpha angle....Continue Reading

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Citations

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