{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T19:09:53Z","timestamp":1792782593986,"version":"4.5.0"},"reference-count":37,"publisher":"Springer Science and Business Media LLC","issue":"11","license":[{"start":{"date-parts":[[2026,7,11]],"date-time":"2026-07-11T00:00:00Z","timestamp":1783728000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,7,11]],"date-time":"2026-07-11T00:00:00Z","timestamp":1783728000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"University of Zurich","id":[{"id":"https:\/\/ror.org\/02crff812","id-type":"ROR","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Pediatr Radiol"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>This study aimed to (1) assess the inter-rater reliability of lateral atlantodental distance measurements in digital open-mouth radiographs of infants with upper cervical spine dysfunction, and (2) investigate correlations between lateral atlantodental distance values and clinical findings.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>72 digital radiographs of the odontoid region from infants aged 3\u201312\u00a0months were analyzed (Aug 2021\u2013Dec 2023). Lateral atlantodental distance was measured bilaterally by three independent raters. Inter-rater reliability and measurement precision was assessed using intraclass correlation coefficients (ICC), standard error of measurement (SEM), and minimal detectable change (MDC). Side differences were evaluated using paired t-tests. Mean lateral atlantodental distance values were further examined for their association with the clinically assessed side of cervical rotational malposition using logistic regression and receiver operating characteristic (ROC) analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Inter-rater reliability was excellent for right (ICC=0.91 [95% CI: 0.86 \u2013 0.94]) and left (ICC=0.91 [95% CI: 0.86 \u2013 0.95]). The SEM was 0.62\u00a0mm for both sides, the MDC was 1.72\u00a0mm (right) and 1.73\u00a0mm (left). In infants with left-sided cervical rotational malposition, lateral atlantodental distance was significantly greater on the left side, whereas in infants with right-sided cervical rotational malposition, lateral atlantodental distance was significantly greater on the right side. Right-sided lateral atlantodental distance was a significant predictor of clinically assessed right-sided cervical rotational malposition (OR 1.80, 95% CI 1.14\u20132.84,\n                      <jats:italic>P<\/jats:italic>\n                      =0.01). ROC analysis demonstrated moderate discriminatory performance (AUC = 0.74), meaning that the model is reasonably capable of distinguishing patients with right-sided cervical rotational malposition from those without.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Although lateral atlantodental distance measurements showed excellent inter-rater reliability, the SEM was relatively large compared with the small absolute values of the measurements (in millimeters), which limits the ability to detect subtle side-to-side asymmetries. Lateral atlantodental distance should be interpreted as a reproducible radiographic finding associated with cervical rotational malposition rather than as an independent diagnostic marker or pathognomonic sign in infants.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration<\/jats:title>\n                    <jats:p>ClinicalTrials.gov ID NCT04981782 (28.07.2021).<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00247-026-06718-8","type":"journal-article","created":{"date-parts":[[2026,7,11]],"date-time":"2026-07-11T08:24:49Z","timestamp":1783758289000},"page":"2573-2580","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Correlation of examiner judgement and radiological digital pictures in infants with upper cervical spine dysfunction: a cross-sectional study"],"prefix":"10.1007","volume":"56","author":[{"given":"Jan","family":"Peter","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miklos","family":"Csato","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Inga","family":"Paravicini","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martina","family":"Wehrli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Petra","family":"Schweinhardt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7570-4289","authenticated-orcid":false,"given":"Anke","family":"Langenfeld","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,7,11]]},"reference":[{"key":"6718_CR1","doi-asserted-by":"publisher","DOI":"10.1136\/adc.2007.124123","author":"L Stellwagen","year":"2008","unstructured":"Stellwagen L, Hubbard E, Chambers C, Jones KL (2008) Torticollis, facial asymmetry and plagiocephaly in normal newborns. 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