It is imperative that pediatric radiologists serve as effective consultants and offer appropriate recommendations as part of a cohesive multidisciplinary approach to this complex patient population.Īcetabular dysplasia Adolescents Children Developmental hip dysplasia Hip Radiography. Pediatric radiologists are often the first to identify borderline or mild dysplasia on radiographs. Summary A simple index calculated by dividing the greater trochanter signal intensity by that of the femoral neck on coronal T1weighted magnetic resonance images of the hip may be useful as an opportunistic screening tool to differentiate normal vs. A hip x-ray, also known as a hip series or hip radiograph, is a pelvis x-ray with an additional lateral view of the specified hip. CT is also helpful for depiction of 3-D acetabular morphology for preoperative assessment and planning. Children with borderline acetabular dysplasia sometimes benefit from other cross-sectional imaging studies such as MR imaging to evaluate for secondary evidence of instability, including damage along the acetabular rim, or labral degeneration and hypertrophy. Although radiographic findings of borderline dysplasia might suggest instability, the ultimate diagnosis is based on history and physical exam in addition to imaging. Some children with borderline radiographic measurements have normal joint mechanics and function while others benefit from acetabular reorienting surgery. An image in this position can be useful in determining: the patellar. In this particular image, primarily the patella is viewed. ![]() Classification of its severity can be assessed by radiographs. Most cases of Legg-Calvé-Perthes disease (LCPD) develop between the ages of 4 and 10 years (Figure 3). Borderline dysplasia generally includes children with a lateral center edge angle (CEA) of 18-24°. Merchant view, or Skyline Merchant View, refers to the position of the x-ray image taken of the knee, where the patient is supine (face up) with their feet hanging off the edge of the exam table at a 45 degree angle. Differences greater than 1.5 mm between the two sides are considered abnormal. All the patients were initially seen in the emergency room for evaluation of hip pain or suspected traumatic fracture.Borderline acetabular dysplasia refers to mildly sub-normal patterns of acetabular shape and coverage that might predispose children to mechanical dysfunction and instability. To examine the role of MRI in such situations, Kirby and Spritzer retrospectively reviewed records of 92 patients who had a total of 97 examinations. When clinicians suspect a fracture that an x-ray doesn't show, MRI often can help them arrive at a conclusive diagnosis, the authors continued. ![]() This review addresses the normal and abnormal radiographic findings that can be encountered during the follow-up of patients with total hip arthroplasty (THA). Use of portable radiography may lead to poor image quality, complicating efforts to exclude traumatic fracture. Part 2: normal and abnormal radiographic findings. Radiographs may be limited by osteopenia, large body size, and issues related to patient positioning. ![]() "Use of MRI has substantial advantage in the detection of pelvic and femoral fractures, helping to steer patients to appropriate medical and surgical therapy."ĭiagnosis of traumatic fracture in the emergency-room setting often begins with radiographs of the hip and pelvis, but in a substantial proportion of cases, diagnosis is not conclusive, the authors noted. Kirby, MD, and Charles Spritzer, MD, wrote. ![]() "We found a large number of both false-positive and false-negative diagnoses based on radiographic findings alone," Matthew W.
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