{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T21:23:35Z","timestamp":1791840215683,"version":"4.3.4"},"reference-count":37,"publisher":"SAGE Publications","issue":"5","license":[{"start":{"date-parts":[[2018,10,1]],"date-time":"2018-10-01T00:00:00Z","timestamp":1538352000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Children's Orthopaedics"],"published-print":{"date-parts":[[2018,10]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>The containment orientated treatment of Legg-Calv\u00e9-Perthes disease (LCPD) affected hip joints is broadly accepted in the literature. The prerequisite is early recognition of loss of containment. An often-used quantitative MRI containment parameter is the cartilaginous acetabulum-head-index (CAHI). Based on ultrasound (US), we analyzed the newly created \u2018femoral head extrusion angle\u2019 (HA) as a containment parameter in comparison with the CAHI in severe LCPD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In a prospective study with 40 children (mean age 5.8 years sd 2.3) with unilateral LCPD classified as Catterall group III\/IV, we measured the CAHI versus HA to assess the containment of the femoral head. HA in US was determined by the tangent from the bony acetabular rim to the cartilaginous cranio-lateral femoral head.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The HA was significantly higher in LCPD-affected hip joints (25\u00b0 sd 7\u00b0) than in healthy ones (13\u00b0 sd 5\u00b0; p &lt; 0.001). Correlation analysis of all hip joints revealed a significant correlation between HA and CAHI (r = \u22120.69; p &lt; 0.001). Hip joints with a low CAHI indicating loss of containment showed a higher HA in sonography.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The results of our study suggest that the HA in US is a reliable containment parameter in severe LCPD with a HA &gt; 22\u00b0 defining a pathologic value. In comparison with the CAHI, HA measurement in ultrasound is easier than the assessment of various parameters to calculate an index. Frequent sonographical follow-up assessment in critical joints is an alternative if MRI is not available, helping to detect an impending loss of containment early enough.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>Level II<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1302\/1863-2548.12.180033","type":"journal-article","created":{"date-parts":[[2018,9,6]],"date-time":"2018-09-06T02:54:47Z","timestamp":1536202487000},"page":"472-479","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":8,"title":["MRI and sonography in Legg-Calv\u00e9-Perthes disease: Clinical relevance of containment and influence on treatment"],"prefix":"10.1177","volume":"12","author":[{"given":"N. M.","family":"Jandl","sequence":"first","affiliation":[{"name":"Department of Orthopaedics, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany"},{"name":"Department of Orthopaedics, Hospital Bad Bramstedt, Bad Bramstedt, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T.","family":"Schmidt","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany"},{"name":"Department of Orthopaedics, Hospital Bad Bramstedt, Bad Bramstedt, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Schulz","sequence":"additional","affiliation":[{"name":"Department of General, Vascular and Visceral Surgery, Hospital Itzehoe, Itzehoe, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"W.","family":"R\u00fcther","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany"},{"name":"Department of Orthopaedics, Hospital Bad Bramstedt, Bad Bramstedt, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. H. 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Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2018,10,1]]},"reference":[{"key":"bibr1-1863-2548.12.180033","doi-asserted-by":"publisher","DOI":"10.1016\/S0030-5898(20)30355-2"},{"key":"bibr2-1863-2548.12.180033","doi-asserted-by":"publisher","DOI":"10.1007\/s00402-002-0445-0"},{"key":"bibr3-1863-2548.12.180033","doi-asserted-by":"publisher","DOI":"10.1007\/s00132-002-0429-3"},{"key":"bibr4-1863-2548.12.180033","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-198163060-00006"},{"key":"bibr5-1863-2548.12.180033","doi-asserted-by":"publisher","DOI":"10.1097\/00003086-198107000-00007"},{"key":"bibr6-1863-2548.12.180033","doi-asserted-by":"publisher","DOI":"10.3109\/17453679209154728"},{"key":"bibr7-1863-2548.12.180033","doi-asserted-by":"publisher","DOI":"10.1055\/s-2008-1080081"},{"key":"bibr8-1863-2548.12.180033","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.90B7.20691"},{"key":"bibr9-1863-2548.12.180033","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-200007000-00010"},{"key":"bibr10-1863-2548.12.180033","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.90B10.20649"},{"key":"bibr11-1863-2548.12.180033","doi-asserted-by":"publisher","DOI":"10.1097\/BPO.0b013e318223b575"},{"key":"bibr12-1863-2548.12.180033","doi-asserted-by":"publisher","DOI":"10.1055\/s-2005-857889"},{"key":"bibr13-1863-2548.12.180033","doi-asserted-by":"publisher","DOI":"10.1097\/01202412-199710000-00002"},{"key":"bibr14-1863-2548.12.180033","doi-asserted-by":"publisher","DOI":"10.1007\/s00132-006-0944-8"},{"key":"bibr15-1863-2548.12.180033","doi-asserted-by":"publisher","DOI":"10.1055\/s-2008-1027366"},{"key":"bibr16-1863-2548.12.180033","doi-asserted-by":"publisher","DOI":"10.1097\/01202412-199907000-00007"},{"key":"bibr17-1863-2548.12.180033","doi-asserted-by":"publisher","DOI":"10.1097\/01241398-199307000-00004"},{"key":"bibr18-1863-2548.12.180033","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1055\/s-2000-13028","volume":"21","author":"Konermann 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