| Objective Measurement of Femoral neck anteversion in children with The dysplasia of the hip is becoming more and more important in clinical practice.(1)Can Murphy's clinical methods replace anatomical methods to measure Femoral neck anteversion angle,and(2)Can MRI replace CT to measure children's Femoral neck anteversion who in The dysplasia of the hip(3)Whether the bone angle and cartilage anteversion angle of the Femoral neck anteversion angle can be replaced.Methods Retrospective analysis of 50 patients 67 hips with The dysplasia of the hip in the outpatient or ward from December 2017 to October 2018.There were 4 males,46 females,11 hips on the right side,11 hips on the left side,22 hips on the left side,and 34 hips on the bilateral side.The average age was 4.64±3.35 years.Image data is saved in DICOM format and measured on a CT workstation PACS system.CT and MRI were performed in the same patient,and the bone and cartilage Femoral neck anteversion were measured by Murphy anatomy and clinical methods.A trained pediatric orthopedic specialist and a bone and muscle professional imaging specialist measured the imaging data of the same child.Paired t-test was used to compare the two groups.The inter-group correlation coefficient(ICC)was used to evaluate the inter-observer consistency,and the Bland-Altman graph was used to analyze the reliability.Result It is the 56 patients with 67 hips,33 were unilateral and 17 were bilateral.(1)Comparison of Morphy anatomy and clinical method of the Femoral neck anteversion angle of skeletal: CT mean anatomical method averaged 40.98 °±13.86 °(range 12.36 °~68.62 °),and healthy side measured mean value 34.69 °±12.31 °(range 12.83 ° ~62.87 °),the difference was statistically significant(t=6.522,p=0.002);the mean value of CT anatomy was 47.84°±11.15 °(range 17.40 °~70.29 °),and the average value of clinical anteversion was 40.24 °±9.20 °(range 19.66 °to 59.67°),the difference was statistically significant(t=8.349,p<0.001).The mean value of MRI healthy side anatomy was 43.26 °±11.69 °(range 11.33 °~80.29 °),and the average value of healthy side clinical method was 40.07°±12.90°(range 13.06 °~77.58 °).The difference was statistically significant(t=2.445,p=0.020).The mean value of the anatomy of the affected side was 48.31 °±10.00 °(range 10.77 °~70.51 °),and the mean value of the clinical method was 42.39 °±12.13 °(range 8.15 °~69.87 °).The difference was statistically significant(t=7.069,p<0.001).CT bone Bland-Altman graph Murphy health side anatomy and clinical method consistent reliability analysis,the baseline of the healthy side is-3.15 °(limit range-8.50 ° ~ 2.20 °);the baseline of the affected side is-3.80 °(limit range-11.11°~3.51°).MRI skeletal Bland-Altman graph Murphy's anatomy and clinical method consistent reliability analysis,the baseline of the healthy side is-1.60 °(limit range-8.83 ° ~ 5.63 °);the baseline of the affected side is-2.66 °(limit range-9.68 ° ~ 3.76 °).(2)Comparison of CT and MRI detection of Murphy anatomy of Murphy: The average value of the health of the Murphy anatomical CT was 40.98°±13.86°(12.36°~68.62°),and the average MRI measurement was 43.26°±11.69.°(11.33 ° ~ 80.29 °),the difference was not statistically significant(t =-1.34,p = 0.119);the mean CT of the affected side was 47.84° ± 11.15°(range 17.40° ~ 70.29°),the average MRI was 48.31° ± 10.01°(The range was 10.77° to 70.51°),and the difference was not statistically significant(t=-0.417,p=0.678).Murphy bone anatomy Bland-Altman graph CT-MRI consistent reliability analysis,the baseline of the contralateral side was-1.14 °(limit range-10.43 ° ~ 8.15 °);the baseline of the affected side was-0.23 °(limit range-9.19 ° ~ 8.72 °).(3)Comparison of the skeletal and cartilage of the femoral neck anteversion angle on the MRI on the MRI: the mean value of the contralateral bone was 43.26°±11.69°(range 11.33°-80.28°),and the mean cartilage average was 43.42°±13.29°(range 4.22°~79.92°).There was no statistically significant difference between the two(t=-0.186,p=0.854);the average bony of the affected side was 48.31°±10.00°(range 10.77°~70.51°),and the mean cartilage rate was 48.86°±12.61°(range 10.16°~83.23°).There was no statistically significant difference between the two(t=-0.534,p=0.595).MRI Murphy anatomical Bland-Altman graph analysis of the skeletal and cartilage consistency of the affected side,the baseline of the healthy side was-0.21 °(limit range-14.79 ° ~ 14.37 °);the baseline of the affected side was-0.21 °(limit range-10.26 ° ~ 9.84 °),the reliability of the affected side is close.(4)Reliability analysis of the anterior tilt angle Murphy anatomy: The ICC of the observer was 0.957(95% CI,0.911-0.979,P<0.05),and the ICC of the MRI was 0.966(95% CI,0.929-0.983).P < 0.05);the ICC of the contralateral CT between the observers was 0.808(95% CI,0.607 to 0.906,P <.05),and the ICR of the MRI was 0.950(95% CI,0.897 to 0.976,P < 0.05).The CT ICC of the affected side was 0.944(95% CI,0.908-0.965,P<0.05),and the ICC of MRI was 0.896(95% CI,0.830~0.936,P<0.05).Reliability between the observers The ICC of CT was 0.961(95% CI,0.937~0.976,P<0.05),and the ICR of MRI was 0.921(95% CI,0.872-0.952,P<0.05).(5)Contrast analysis of CT-MRI of the Femoral Neck Anteversion angle Murphy anatomy: The consistency of the CT-MRI contralateral ICC was 0.836(95% CI,0.665~0.920,P<0.05),and the CT-MRI affected side was consistent.The ICC was 0.772(95% CI,0.629~0.860,P<0.05).Conlusion In the measurement of Femoral neck anteversion angle in children with DDH,MRI provides a precise,reliable,and repeatable measure of comparison with CT;there is a significant correlation between Murphy clinical and anatomical methods,and cannot be replaced unconditionally;There is no significant difference between the cartilage anteversion angle and the mutual application in practical applications.Level of Evidence: Level ? 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