An interventional study of Repeat hip ultrasound measurements in Developmental Dysplasia of the Hip, sponsored by Aarhus University Hospital. Completed at 1 site in Denmark. Open to participants aged 0 Months to 6 Months, including healthy volunteers. Per ClinicalTrials.gov, last updated 2026-02-10.
Sponsored by Aarhus University Hospital · Not applicable, Interventional, and Diagnostic
Several measurements are used to evaluate hip dysplasia in hip ultrasound of children. Despite having being used since the 1980s, reliability studies have failed to find acceptable reliaiblity values for the gold standard ultrasound methods.
This study will evaluate three ultrasound measurement methodologies in a high quality controlled setting, to investigate the best achieveable reliability and agreement of the investigated measurements used in hip dysplasia diagnostics.
In DDH diagnostics, measurements of acetabular alpha angles and femoral head coverages (FHC), developed by Graf and Harcke/Terjesen respectively, have been gold standard since the 1980s. Despite their widespread use, the reliability of these measurements has been questioned due to the relative complexity of acquiring the necessary corIDrect frontal 2D plane or "standard plane". In the only meta-analysis of the reliability of ultrasound (US) metrics in dysplasia, the interrater reliability of the alpha angles was mediocre while the reliability of the FHC was poor. Critics of these findings however argue that the low reliability reported in studies are due to misinterpretation and misapplication of the Graf method.
The pubo-femoral distance (PFD) was proposed in 2013 as a new measurement for assessing DDH, while the reliability is reportedly higher than the gold standard US methods, it has never been directly compared to these.
This study aims to evaluate the inter- and intrarater reliability of Graf's alpha and beta angles, the FHC and PFD in children referred for hip US in a selective ultrasound screening program for DDH.
114 studies on the registry are indexed under Developmental Dysplasia of the Hip; 17 are open to participants now.
This study's enrollment of 74 is above the median of 61 across 71 interventional studies indexed under Developmental Dysplasia of the Hip.
Browse Developmental Dysplasia of the Hip studies →Aarhus University Hospital is the lead sponsor of 289 studies on the registry; 79 are open to participants now.
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Exclusion Criteria:
All included children will have double measurements of the investigated ultrasound methodologies performed by two separate musculoskeletal radiologists.
Diagnostic Test: Repeat hip ultrasound measurements
See earlier
Reliability and agreement in Alpha/Beta angles, Femoral head coverage and Pubo-femoral distance
For all included ultrasound measurement methods the following will be reported: Inter- and intrarater reliability will be evaluated using the intraclass correlation coefficient (ICC) and interpreted with ICC values between 0-0.5, 0.5-0.75, 0.75-0.9 and above 0.9 indicating poor, moderate, good and excellent reliability respectively. Agreement will be evaluated using Bland-Altman plots (to check for systematic bias) and mean absolute measurement differences between raters.
Time frame: Ultrasound measurements collected during the ultrasound examination by both radiologists
Plan to share: Yes — Study protocol, analysis plan, and analytic code will be available upon written request to the first author.
Supporting information: Study protocol, Sap, Analytic code
No publications or documents are linked to this record.
This study is completed, as verified in Feb 2026. You cannot join it, but the record below documents what was studied.
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Developmental Dysplasia of the Hip→
Aarhus University Hospital