Background: Reliable assessment of hip dysplasia and osteoarthritis is crucial in young adults who may benefit from joint-preserving surgery.
Purpose: To investigate the variability of different methods for diagnostic assessment of hip dysplasia and osteoarthritis.
Material and Methods: By each of four observers, two assessments were done by vision and two by angle construction. For both methods, the intra- and interobserver variability of center-edge and acetabular index angle assessment were analyzed. The observers’ ability to diagnose hip dysplasia and osteoarthritis were assessed. All measures were compared to those made on computed tomography scan.
Results: Intra- and interobserver variability of angle assessment was less when angles were drawn compared with assessment by vision, and the observers’ ability to diagnose hip dysplasia improved when angles were drawn. Assessment of osteoarthritis in general showed poor agreement with findings on computed tomography scan.
Conclusion: We recommend that angles always should be drawn for assessment of hip dysplasia on pelvic radiographs. Given the inherent variability of diagnostic assessment of hip dysplasia, a computed tomography scan could be considered in patients with relevant hip symptoms and a center-edge angle between 20° and 30°. Osteoarthritis should be assessed by measuring the joint space width or by classifying the Tönnis grade as either 0–1 or 2–3.
