The main aim of this study was to validate the anteroposterior pelvis radiography (AP Rx) of load-bearing hips as a test to measure lower limb length discrepancy (LLD) and compare this with upright full-length radiography of load-bearing lower limbs.
Another aim was to verify inter-observer and intra-observer reliability of the different radiographic measurements for LLD and compare different radiographic measurements taken for the LLD study.
Each participant underwent an upright full-length radiographic test for load-bearing lower limbs and an anteroposterior load-bearing hip radiograph according to the same protocol.
Upright full-length radiography measured lower limb length using the following bilateral reference points: higher point of the head of the femur, central point of the head of the femur, upper acetabular lip, most prominent point of the lesser trochanter, lower part of the ischial tuberosity, and medial point of the underside of the tibia.
For the hip radiograph, the following bilateral reference points: higher point of the head of the femur, central point of the head of the femur, upper acetabular lip, most prominent point of the lesser trochanter, lower part of the ischial tuberosity, and medial point of the underside of the tibia.
There was a strong and positive correlation between all of the measurements taken in the hip and LLD measurements.
Inter-observer and intra-observer reliability was high for all of the measurements because the intraclass correlation was greater than 0.75 in all of the cases.
There was a strong and positive correlation between the different measurements because when performing bivariate correlations with the Pearson correlation coefficient, positive values close to 1 were found.
This proved that the different reference points reported in the upright full-length radiograph in addition to the hip radiographs are useful for assessing lower limb length discrepancy.
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