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Simple Summary: Canine hip dysplasia is a painful condition common in large dog breeds, leading to joint instability and osteoarthritis. Accurate diagnosis is crucial for guiding breeding decisions to help reduce its prevalence. However, evaluating hip health status can be challenging, as minor positioning changes during X-rays can distort images and hinder proper hip joint assessment. In this study, we developed an artificial intelligence tool for the automatic evaluation of pelvic alignment in X-rays. By detecting subtle asymmetries in bone structure, the tool determines whether a dog's hips are properly aligned. Our findings showed that the artificial intelligence tool performed as accurately as an expert human examiner in detecting misalignment. This automated approach could improve the reliability of canine hip dysplasia screenings, saving veterinarians time and reducing misdiagnosis risks due to human error. Ultimately, this technology has the potential to enhance medical care for dogs and support breeders in making more informed choices, contributing to canine health improvements and reducing canine hip dysplasia incidence in future generations. Canine hip dysplasia (CHD) screening relies on accurate positioning in the ventrodorsal hip extended (VDHE) view, as even mild pelvic rotation can affect CHD scoring and impact breeding decisions. This study aimed to assess the association between pelvic rotation and asymmetry in obturator foramina areas (AOFAs) and to develop a computer vision model for automated AOFA measurement. In the first part, 203 radiographs were analyzed to examine the relationship between pelvic rotation, assessed through asymmetry in iliac wing and obturator foramina widths (AOFWs), and AOFAs. A significant association was found between pelvic rotation and AOFA, with AOFW showing a stronger correlation (R2 = 0.92, p < 0.01). AOFW rotation values were categorized into minimal (n = 71), moderate (n = 41), marked (n = 37), and extreme (n = 54) groups, corresponding to mean AOFA ± standard deviation values of 33.28 ± 27.25, 54.73 ± 27.98, 85.85 ± 41.31, and 160.68 ± 64.20 mm2, respectively. ANOVA and post hoc testing confirmed significant differences in AOFA across these groups (p < 0.01). In part two, the dataset was expanded to 312 images to develop the automated AOFA model, with 80% allocated for training, 10% for validation, and 10% for testing. On the 32 test images, the model achieved high segmentation accuracy (Dice score = 0.96; Intersection over Union = 0.93), closely aligning with examiner measurements. Paired t-tests indicated no significant differences between the examiner and model's outputs (p > 0.05), though the Bland–Altman analysis identified occasional discrepancies. The model demonstrated excellent reliability (ICC = 0.99) with a standard error of 17.18 mm2. A threshold of 50.46 mm2 enabled effective differentiation between acceptable and excessive pelvic rotation. With additional training data, further improvements in precision are expected, enhancing the model's clinical utility. [ABSTRACT FROM AUTHOR]

Simple Summary: Radiographic diagnosis is essential for the genetic control of canine hip dysplasia (HD). The Fédération Cynologique Internationale (FCI) scoring HD scheme is based on objective and qualitative radiographic criteria. Subjective interpretations can lead to errors in diagnosis and, consequently, to incorrect selective breeding, which in turn impacts the gene pool of dog breeds. The aim of this study was to use a computer method to calculate the Hip Congruency Index (HCI) to objectively estimate radiographic hip congruency for future application in the development of computer vision models capable of classifying canine HD. The HCI measures the percentage of acetabular coverage that is occupied by the femoral head. Normal hips are associated with an even, parallel joint surface that translates into reduced acetabular free space, which increases with hip subluxation and becomes maximal in hip dislocation. We found statistically significant differences in mean HCI values among all five FCI categories. These results demonstrate that the HCI reliably reflects the different degrees of congruency associated with HD. Therefore, it is expected that when used in conjunction with other HD evaluation parameters, such as Norberg angle and assessment of osteoarthritic signs, it can improve the diagnosis by making it more accurate and unequivocal. Accurate radiographic screening evaluation is essential in the genetic control of canine HD, however, the qualitative assessment of hip congruency introduces some subjectivity, leading to excessive variability in scoring. The main objective of this work was to validate a method-Hip Congruency Index (HCI)-capable of objectively measuring the relationship between the acetabulum and the femoral head and associating it with the level of congruency proposed by the Fédération Cynologique Internationale (FCI), with the aim of incorporating it into a computer vision model that classifies HD autonomously. A total of 200 dogs (400 hips) were randomly selected for the study. All radiographs were scored in five categories by an experienced examiner according to FCI criteria. Two examiners performed HCI measurements on 25 hip radiographs to study intra- and inter-examiner reliability and agreement. Additionally, each examiner measured HCI on their half of the study sample (100 dogs), and the results were compared between FCI categories. The paired t-test and the intraclass correlation coefficient (ICC) showed no evidence of a systematic bias, and there was excellent reliability between the measurements of the two examiners and examiners' sessions. Hips that were assigned an FCI grade of A (n = 120), B (n = 157), C (n = 68), D (n = 38) and E (n = 17) had a mean HCI of 0.739 ± 0.044, 0.666 ± 0.052, 0.605 ± 0.055, 0.494 ± 0.070 and 0.374 ± 0.122, respectively (ANOVA, p < 0.01). Therefore, these results show that HCI is a parameter capable of estimating hip congruency and has the potential to enrich conventional HD scoring criteria if incorporated into an artificial intelligence algorithm competent in diagnosing HD. [ABSTRACT FROM AUTHOR]