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Ultrasound hip evaluation in achondroplasia
Maurizio De Pellegrin1, Desiree Moharamzadeh
1Department of Orthopaedics, Service of Pediatric Orthopaedics, Vita-Salute University, IRCCS San Raffaele Hospital, Milan, Italy. depellegrin.maurizio@hsr.it
Insights
Hip ultrasound in achondroplasia reveals characteristic acetabular development. This imaging technique aids in the early diagnosis of hip abnormalities in children with achondroplasia.
Area of Science:
- Pediatric Orthopedics
- Medical Imaging
- Skeletal Dysplasias
Background:
- Achondroplasia is a common skeletal dysplasia affecting bone growth.
- Hip abnormalities are a frequent complication in children with achondroplasia.
- Early diagnosis and monitoring of hip development are crucial.
Purpose of the Study:
- To evaluate the characteristic hip ultrasound findings in children with achondroplasia.
- To assess the utility of ultrasound in diagnosing hip alterations in this population.
- To correlate ultrasound parameters with patient age.
Main Methods:
- Retrospective analysis of hip ultrasound (US) examinations in 22 children (44 hips) with achondroplasia.
- US performed using Graf's method with specific probes.
- Evaluation of acetabular rim and roof, cartilage echogenicity, femoral head coverage, beta angle, hip stability, and ossific nucleus presence.
Main Results:
- All hips demonstrated a sharp acetabular rim, horizontal roof, and thickened cartilage.
- Femoral head coverage averaged 86.7%, increasing with age.
- The mean beta angle was 20 degrees, decreasing with age.
- All hips were stable, and the ossific nucleus was present in 5 children.
Conclusions:
- Hip ultrasonography reveals specific anatomical alterations in the acetabulum of children with achondroplasia.
- These characteristic findings support the use of ultrasound for early diagnosis.
- Ultrasound can detect altered acetabular development, aiding in management.
Background:
During the period from 1985 to 2006, 22 children (44 hips) affected by achondroplasia were ultrasonographically evaluated.
Methods:
The patients' age at examination ranged from 7 days to 29 months. The hip ultrasound (US) examination was performed, according to Graf's method, using a Siemens Sonoline sonogram with linear 5.0- and 7.5-MHz probes. In all the hips, the alpha angle was impossible to be measured because the medial margin of the ilium was not ultrasonographically detectable. The ultrasonographic findings included the following: configuration of the acetabular bony rim, configuration of the acetabular roof, echogenicity of the head and acetabular cartilage, bony coverage percentage of the femoral head according to Morin et al, beta angle according to Graf, dynamic hip instability, and presence of the proximal femoral ossific nucleus.
Results:
All hips had a sharp acetabular bony rim, a horizontal acetabular roof, thickened acetabular cartilage, and normal echogenicity. The femoral head was well centered and deeply contained in the acetabular fossa. The mean coverage was 86.7% (range: 78%-90%) and showed progressively larger values with increasing age. The mean value of the beta angle was 20 degrees (range: 8 degrees-38 degrees). The value of the beta angle tended to decrease as age increased. No difference was observed between the right and the left hip in both measurements. All hips were stable. The ossific nucleus was present in 5 children.
Conclusions:
The characteristic findings in hip ultrasonography in children with achondroplasia can aid in its early diagnosis because ultrasound can anatomically detect the altered development of the achondroplastic acetabulum.
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