Current and Emerging Applications of Artificial Intelligence in Medical Imaging for Paediatric Hip Disorders-A...

Paediatric hip disorders present unique challenges for artificial intelligence (AI)-aided assessments of medical imaging due to disease-related and age-dependent changes in hip morphology. This scoping review aimed to describe current and emerging applications of AI in medical imaging for paediatric hip disorders.

A descriptive synthesis of articles identified through PubMed, Embase, Cochrane Library, Web of Science, Emcare, and Academic Search Premier databases was performed including articles published up until June 2024. Original research articles' titles and abstracts were screened, followed by full-text screening. Two reviewers independently conducted article screening and data extraction (i.e., data on the article and the model and its performance).

Out of 871 unique articles, 40 were included. The first article was dated from 2017, with annual publication rates increasing thereafter. Research contributions were primarily from China (17 [43%]) and Canada (10 [25%]). Articles mainly focused on developing novel AI models (19 [47.5%]), applied to ultrasound images or radiographs of developmental dysplasia of the hip (DDH; 37 [93%]). The three remaining articles addressed Legg-Calvé-Perthes disease, neuromuscular hip dysplasia in cerebral palsy, or hip arthritis/osteomyelitis. External validation was performed in eight articles (20%). Models were mainly applied to the diagnosis/grading of the disorder (22 [55%]), or on screening/detection (17 [42.5%]). AI models were 17 to 124 times faster (median 30) in performing a specific task than experienced human assessors, with an accuracy of 86-100%.

Research interest in AI applied to medical imaging of paediatric hip disorders has expanded significantly since 2017, though the scope remains restricted to developing novel models for DDH imaging. Future studies should focus on (1) the external validation of existing models, (2) implementation into clinical practice, addressing the current lack of implementation efforts, and (3) paediatric hip disorders other than DDH.