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Research ArticleArticle

Comparison of Lifts Versus Tape Measure in Determining Leg Length Discrepancy

Maziar Badii, A. Nicole Wade, David R. Collins, Savvakis Nicolaou, B. Jacek Kobza and Jacek A. Kopec
The Journal of Rheumatology August 2014, 41 (8) 1689-1694; DOI: https://doi.org/10.3899/jrheum.131089
Maziar Badii
From the Division of Rheumatology, Department of Medicine, and the Department of Radiology, and the Department of Health Care and Epidemiology, University of British Columbia (UBC); Pacific Arthritis Center, Vancouver, British Columbia, Canada.
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A. Nicole Wade
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  • For correspondence: a.nicolewade@gmail.com
David R. Collins
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Savvakis Nicolaou
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B. Jacek Kobza
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Jacek A. Kopec
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Abstract

Objective. To evaluate the validity (accuracy) and reliability of 2 commonly used clinical methods, 1 indirect (lifts) and 1 direct (tape measure), for assessment of leg length discrepancy (LLD) in comparison to radiograph.

Methods. Twenty subjects suspected of having LLD participated in this study. Two clinical methods, 1 direct using a tape measure and 1 indirect using lifts, were standardized and carried out by 4 examiners. Difference in height of the femoral heads on standing pelvic radiograph was measured and served as the gold standard.

Results. The intraclass correlation coefficient assessing interobserver reliability was 0.737 for lifts and 0.477 for tape measure. The remainder of the analysis is based on the average of the measurements by the 4 examiners. Pearson correlation coefficients were 0.93 for the lifts and 0.75 for the tape measure method. Paired sample t tests showed difference in means of 2 mm (p = 0.051) for lifts and −5 mm (p = 0.007) for tape measure compared with radiograph. Sensitivity and specificity were 55% and 89% for lifts and 45% and 56% for tape measure, respectively, using > 5 mm as the definition for LLD. The wrong leg was identified as being shorter in 1 out of 20 subjects using lifts versus 7 out of 20 using tape measure.

Conclusion. The indirect standing method of LLD measurement using lifts had superior validity, interobserver reliability, and specificity in comparison with radiograph over the direct supine method using tape measure. Both clinical methods underestimated LLD compared with radiograph.

Key Indexing Terms:
  • LEG LENGTH DISCREPANCY
  • CLINICAL METHODS
  • RADIOGRAPH
  • Accepted for publication April 4, 2014.
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The Journal of Rheumatology
Vol. 41, Issue 8
1 Aug 2014
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Comparison of Lifts Versus Tape Measure in Determining Leg Length Discrepancy
Maziar Badii, A. Nicole Wade, David R. Collins, Savvakis Nicolaou, B. Jacek Kobza, Jacek A. Kopec
The Journal of Rheumatology Aug 2014, 41 (8) 1689-1694; DOI: 10.3899/jrheum.131089

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Comparison of Lifts Versus Tape Measure in Determining Leg Length Discrepancy
Maziar Badii, A. Nicole Wade, David R. Collins, Savvakis Nicolaou, B. Jacek Kobza, Jacek A. Kopec
The Journal of Rheumatology Aug 2014, 41 (8) 1689-1694; DOI: 10.3899/jrheum.131089
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Keywords

LEG LENGTH DISCREPANCY
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  • LEG LENGTH DISCREPANCY
  • CLINICAL METHODS
  • RADIOGRAPH

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