Arthrography of the hip in children. Technique, normal anatomy and findings in unstable hip joints
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Bilateral hip arthrography in children effectively diagnoses hip instability and guides treatment. This method provides crucial details on joint anatomy, aiding in successful closed reduction and timely intervention.
Area of Science:
- Pediatric Orthopedics
- Diagnostic Imaging
- Radiology
Background:
- Congenital idiopathic hip instability is a common condition in infants, often presenting in girls.
- Early detection and accurate assessment are crucial for effective treatment of hip instability.
- Adductor muscle contractures can complicate hip joint evaluation.
Purpose of the Study:
- To describe a standardized method for bilateral hip arthrography in pediatric patients.
- To evaluate the diagnostic utility of arthrography in assessing hip joint anatomy and instability.
- To present criteria for normal hip joint appearance in infants.
Main Methods:
- Bilateral hip arthrography performed under general anesthesia in 130 infants and children (1 month to 7 years).
- Pre-examination correction of significant adductor muscle contractures.
- Standardized radiographic projections and stereoradiography for detailed joint evaluation.
Main Results:
- Arthrography provided valuable information on joint cavity configuration, femoral head size/shape, and contrast distribution.
- Stereoradiography enhanced visualization of articular surface relationships and acetabular anatomy.
- Normal radiographic criteria for infants aged 2-12 months were established.
Conclusions:
- Bilateral hip arthrography is a valuable diagnostic tool for pediatric hip instability.
- The procedure facilitates successful closed reduction during the examination.
- This enables prompt initiation of definitive treatment under the same anesthesia.
Abstract:
A method by which bilateral hip arthrography was performed under general anaesthesia in 130 infants and children 1 month to 7 years of age is described. Significant contractures of the adductor muscles had been corrected before the examination. Most of the children were girls with unilateral congenital idiopathic hip instability detected before the age of one year. From films exposed in standardized projections valuable information was obtained about the configuration of the joint cavity and the size and shape of the femoral head. Criteria for normal appearance in infants of ages 2 to 12 months are presented. More reliable details on the relation between the articular surfaces, the radiographic anatomy of the acetabulum and the distribution of the contrast medium were yielded by stereoradiography. Closed reduction was usually accomplished successfully during the arthrography, which made beginning of definitive treatment under the same anaesthesia possible.