[Preoperative diagnostic imaging and planning]

Area of Science:

• Radiology
• Orthopedic Surgery
• Medical Imaging

Background:

• Accurate radiographic technique, image quality, and interpretation are fundamental for surgical planning.
• Thorough evaluation of hip pathology via imaging is essential for successful long-term outcomes in hip and pelvis osteotomy.

Purpose of the Study:

• To provide an overview of the performance, quality criteria, and interpretation of essential hip radiographic images.
• To highlight the significance of various imaging modalities in surgical planning for hip conditions.

Main Methods:

• Review of standard radiographic views for hip assessment.
• Description of specific projections: anterior-posterior pelvic view, Rippstein II projection, and Lequesne's false-profile view.
• Mention of Computed Tomography (CT) for 3D planning and Magnetic Resonance Imaging (MRI) with MR-arthrography for soft tissue evaluation.

Main Results:

• The anterior-posterior pelvic view is primary for osteotomy planning, allowing CCD angle calculation.
• Rippstein II projection is used for femoral antetorsion (AT-angle) measurement.
• Lequesne's false-profile view assesses anterior femoral head coverage.
• Pelvic hip views in children are vital for hip dysplasia evaluation, using lines/angles like Hilgenreiner, Perkin, AC-angle, and Reimers migration index.
• CT offers precise 3D planning and AT-angle measurement.

Conclusions:

• MRI, particularly MR-arthrography, aids in diagnosing hip pathologies like labrum and cartilage injuries.
• Radiographic interpretation is key to successful hip surgery outcomes.