Precision, reproducibility, and clinical usefulness of measuring the Norberg angle by means of computerized image analysis

Abstract

Objective - To evaluate the precision, reproducibility, and clinical usefulness of measuring the Norberg angle (NA) by means of a computerized system of image analysis. Sample Population - 1,182 consecutive radiographs of hip joints of various breeds of dogs assessed for hip dysplasia and 72 radiographs of hip joints of German Shepherd Dogs. Procedures - Radiographs were assessed by a panel of 4 experts in consensus, and NAs were measured by means of a computerized system. Results of classification of hip dysplasia according to the Fédération Cynologique Internationale (FCI) and NAs were compared within dogs and among breeds. Results - Measurement of the NA by means of image analysis was twice as reproducible as that via calipers. Mean NA of left hip joints was 0.38° higher than that of right hip joints. The NA values accurately discriminated between hip joints of dogs without or with hip dysplasia, provided the values were also expressed as percentile rank based on the cumulative frequency distribution of NAs within the breed, and had good power to discriminate among various FCI classifications of hip joints. Mean NA for each dog breed as calculated by use of the lower of 2 NAs for each dog was highly variable and was moderately correlated with the existence of hip dysplasia (r = 0.5). Conclusions and Clinical Relevance - Computer-assisted measurement of the NA was useful in assessing hip joint quality and can be implemented for quality control and standardization of the FCI classification and for international comparisons.