{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T16:34:32Z","timestamp":1791477272253,"version":"4.3.4"},"reference-count":14,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2020,10,2]],"date-time":"2020-10-02T00:00:00Z","timestamp":1601596800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2020,10,2]],"date-time":"2020-10-02T00:00:00Z","timestamp":1601596800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Medizinisch-Wissenschaftlicher Fonds des B\u00fcrgermeisters der Bundeshauptstadt Wien","award":["15144"],"award-info":[{"award-number":["15144"]}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Sci Rep"],"abstract":"<jats:title>Abstract<\/jats:title><jats:p>To develop an electronic navigation system to increase reliability and comparability in the ultrasound screening of developmental dysplasia of the hip (DDH). The impact of the navigation system on transducer positioning and on sonographic measurements according to Graf was analyzed. Twenty hips in newborns were examined sonographically using a new navigation system capable of detecting the transducer and pelvis position in order to calculate the relative tilt in the frontal, axial, and sagittal-plane. In each newborn an ultrasound image was obtained conventionally according to Graf and a second image using the sonographic navigation system. Relative roll and pitch angles and sonographic measurements were analyzed using paired T-tests and Levene-tests. Relative tilt angles in the conventional group ranged from \u2212 8.9\u00b0 to 14.3\u00b0 (frontal-plane) and \u2212 23.8\u00b0 to 14.2\u00b0 (axial-plane). In the navigation-assisted group ranges from \u2212 3.0\u00b0 to 3.5\u00b0 and \u2212 2.8\u00b0 to 4.5\u00b0 were observed. Variances were significantly lower in the navigation-assisted group (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001 and <jats:italic>p<\/jats:italic>\u2009=\u20090.004 respectively). The navigation system allowed for a significant reduction of relative tilt angles between the transducer and the newborn pelvis, thus supporting an optimal transducer positioning. This is a promising approach to improve reproducibility and reliability in the ultrasound screening for DDH.<\/jats:p>","DOI":"10.1038\/s41598-020-73536-9","type":"journal-article","created":{"date-parts":[[2020,10,2]],"date-time":"2020-10-02T10:04:52Z","timestamp":1601633092000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Development of an electronic navigation system for elimination of examiner-dependent factors in the ultrasound screening for developmental dysplasia of the hip in newborns"],"prefix":"10.1038","volume":"10","author":[{"given":"Alexander","family":"Kolb","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catharina","family":"Chiari","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Markus","family":"Schreiner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephan","family":"Heisinger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Madeleine","family":"Willegger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregor","family":"Rettl","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reinhard","family":"Windhager","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2020,10,2]]},"reference":[{"key":"73536_CR1","doi-asserted-by":"publisher","first-page":"735","DOI":"10.1097\/01241398-198411000-00015","volume":"4","author":"R Graf","year":"1984","unstructured":"Graf, R. Fundamentals of sonographic diagnosis of infant hip dysplasia. J. Pediatr. Orthop. 4, 735\u2013740 (1984).","journal-title":"J. Pediatr. Orthop."},{"key":"73536_CR2","doi-asserted-by":"publisher","first-page":"354","DOI":"10.1097\/01241398-198307000-00015","volume":"3","author":"R Graf","year":"1983","unstructured":"Graf, R. New possibilities for the diagnosis of congenital hip joint dislocation by ultrasonography. J. Pediatr. Orthop. 3, 354\u2013359 (1983).","journal-title":"J. Pediatr. Orthop."},{"key":"73536_CR3","first-page":"671","volume":"134","author":"EA Simon","year":"2004","unstructured":"Simon, E. A. et al. Inter-observer agreement of ultrasonographic measurement of alpha and beta angles and the final type classification based on the Graf method. Swiss Med. Wkly. 134, 671\u2013677 (2004).","journal-title":"Swiss Med. Wkly."},{"key":"73536_CR4","doi-asserted-by":"publisher","first-page":"119","DOI":"10.1097\/01.blo.0000203475.73678.be","volume":"447","author":"A Roposch","year":"2006","unstructured":"Roposch, A., Graf, R. & Wright, J. G. Determining the reliability of the Graf classification for hip dysplasia. Clin. Orthop. Relat. Res. 447, 119\u2013124 (2006).","journal-title":"Clin. Orthop. Relat. Res."},{"key":"73536_CR5","doi-asserted-by":"publisher","DOI":"10.1007\/s00264-015-2799-2","author":"A Kolb","year":"2015","unstructured":"Kolb, A. et al. Low incidence of early developmental dysplasia of the hip in universal ultrasonographic screening of newborns: analysis and evaluation of risk factors. Int. Orthop. https:\/\/doi.org\/10.1007\/s00264-015-2799-2 (2015).","journal-title":"Int. Orthop."},{"key":"73536_CR6","doi-asserted-by":"publisher","first-page":"299","DOI":"10.11152\/mu.2013.2066.154.rg2","volume":"15","author":"R Graf","year":"2013","unstructured":"Graf, R., Mohajer, M. & Plattner, F. Hip sonography update. Quality-management, catastrophes\u2014tips and tricks. Med. Ultrason. 15, 299\u2013303 (2013).","journal-title":"Med. Ultrason."},{"key":"73536_CR7","first-page":"14","volume":"26","author":"R Graf","year":"1997","unstructured":"Graf, R. Hip ultrasonography. Basic principles and current aspects. Orthopade 26, 14\u201324 (1997).","journal-title":"Orthopade"},{"key":"73536_CR8","doi-asserted-by":"publisher","first-page":"870","DOI":"10.1148\/radiol.14140451","volume":"273","author":"JL Jaremko","year":"2014","unstructured":"Jaremko, J. L. et al. Potential for change in US diagnosis of hip dysplasia solely caused by changes in probe orientation: patterns of alpha-angle variation revealed by using three-dimensional US. Radiology 273, 870\u2013878 (2014).","journal-title":"Radiology"},{"key":"73536_CR9","doi-asserted-by":"publisher","first-page":"1245","DOI":"10.1007\/s00264-017-3455-9","volume":"41","author":"A Kolb","year":"2017","unstructured":"Kolb, A. et al. Measurement considerations on examiner-dependent factors in the ultrasound assessment of developmental dysplasia of the hip. Int. Orthop. 41, 1245\u20131250 (2017).","journal-title":"Int. Orthop."},{"key":"73536_CR10","doi-asserted-by":"publisher","first-page":"18","DOI":"10.1007\/s00264-017-3455-9","volume":"782","author":"A Kolb","year":"2019","unstructured":"Kolb, A. Electronic transducer guiding device for the sonographic screening for developmental dysplasia of the hip. MUW Technol. Offer. 782, 18. https:\/\/doi.org\/10.1007\/s00264-017-3455-9 (2019).","journal-title":"MUW Technol. Offer."},{"key":"73536_CR11","first-page":"33","volume":"26","author":"R Graf","year":"1997","unstructured":"Graf, R. Ultrasonography-guided therapy. 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One of the authors (RW) has received institutional funding from Stryker, DePuy Synthes Austria, Johnson & Johnson Medical Limited, Medacta, Zimmer Biomet Gmbh.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"16407"}}