Klever et al: Influence of Femoral Position and Pelvic Projection on Norberg Angle Measurements
Veterinary and Comparative Orthopedics and Traumatology 1, 2024

🔍 Key Findings

  • Dorsoventral radiographs artificially increase Norberg angle values by 3.2–5.8% and should be excluded.
  • Lateral pelvic tilt >2° causes asymmetric changes in Norberg angle; >3° results in significant side-specific changes.
  • Cranioventral-to-caudodorsal tilt >10° results in obvious radiographic tilt, but changes Norberg angle by only ~2%.
  • Tilted but subjectively acceptable images have minor impact and may still be usable for screening.
  • Norberg angle readings differed consistently between left/right hips — possibly due to operator handedness.

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Klever et al: Influence of Femoral Position and Pelvic Projection on Norberg Angle Measurements
Veterinary and Comparative Orthopedics and Traumatology 1, 2024

🔍 Key Findings

  • Dorsoventral radiographs artificially increase Norberg angle values by 3.2–5.8% and should be excluded.
  • Lateral pelvic tilt >2° causes asymmetric changes in Norberg angle; >3° results in significant side-specific changes.
  • Cranioventral-to-caudodorsal tilt >10° results in obvious radiographic tilt, but changes Norberg angle by only ~2%.
  • Tilted but subjectively acceptable images have minor impact and may still be usable for screening.
  • Norberg angle readings differed consistently between left/right hips — possibly due to operator handedness.

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Multiple Choice Questions on this study

In Klever 2024 et al., what is the minimum degree of lateral pelvic tilt that significantly alters Norberg angle on one side?

A. 1 degree
B. 2 degrees
C. 3 degrees
D. 5 degrees
E. 10 degrees

Answer: 3 degrees

Explanation: Tilt of 3 degrees caused statistically significant asymmetry in Norberg angle between sides
In Klever 2024 et al., what effect does a dorsoventral projection have on Norberg angle measurements?

A. No measurable change
B. Decreases both hips' angles
C. Increases angle by ~2%
D. Increases angle by 3–6%
E. Lateralizes the femoral head

Answer: Increases angle by 3–6%

Explanation: Dorsoventral projection increased Norberg angle by 3.2–5.8%, potentially overestimating joint congruity
In Klever 2024 et al., what factor helps visually identify a dorsoventral rather than ventrodorsal pelvic projection?

A. Wider obturator foramen
B. Femoral heads appear asymmetric
C. Patella more proximally projected
D. Symphyseal angle wider
E. Sacral canal more visible

Answer: Patella more proximally projected

Explanation: Dorsoventral views project the patella more proximally on the femur
In Klever 2024 et al., what degree of cranial–caudal pelvic tilt was required before observers consistently perceived images as "tilted"?

A. >3 degrees
B. >5 degrees
C. >7 degrees
D. >10 degrees
E. >15 degrees

Answer: >10 degrees

Explanation: Only tilt >10° was consistently perceived as visibly tilted (sensitivity 0.76, specificity 1.0)
In Klever 2024 et al., which statement about evaluating Norberg angle on laterally tilted radiographs is correct?

A. Averaging both hips is reliable
B. Only left side increases with tilt
C. Radiographs must be excluded if >1°
D. Norberg angles may balance but averaging is not advised
E. Only dorsal tilt affects results

Answer: Norberg angles may balance but averaging is not advised

Explanation: Though values may counterbalance, averaging should not be used clinically

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