Radiographic measurements of dysplastic adult hips

Hip dysplasia is a not uncommon feature in adults and can vary from subtle acetabular dysplasia to complex sequelae of developmental dysplasia of the hip. This review article describes the most useful radiographic measurements used to evaluate the adult hip. The frontal projection of the pelvis permits measurement of the center-edge angle (CE angle) and "horizontal toit externe" angle (HTE angle), both of which assess the superior coverage of the acetabulum. The femoral neck-shaft angle (NSA) is also measured on this view. The false profile radiograph of the pelvis is described. It allows measurement of the vertical-center-anterior angle (VCA angle), which determines the anterior acetabular coverage and detects early degenerative hip joint disease. When surgery is contemplated, computed tomography (CT) is useful to better determine the anterior acetabular coverage by use of the anterior acetabular sector angle (AASA), and the posterior acetabular coverage by use of the posterior acetabular sector angle (PASA). CT also permits measurement of femoral anteversion. These measurements are particularly useful in the evaluation of acetabular dysplasia and for the preoperative assessment of the dysplastic hip.