Radiologic pelvic asymmetry in unilateral late-diagnosed developmental dysplasia of the hip
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J Albiñana1, J A Morcuende, E Delgado
1Hospital Niño Jesus, Madrid, Spain.
Insights
Late-diagnosed developmental dysplasia of the hip (DDH) shows significant pelvic asymmetry. This pelvic shape alteration in DDH may stem from growth disturbances in the triradiate cartilage.
Area of Science:
- Orthopedics
- Radiology
- Pediatric Medicine
Background:
- Developmental dysplasia of the hip (DDH) is a common pediatric condition.
- Late diagnosis of DDH can complicate treatment and outcomes.
- Pelvic morphology plays a crucial role in hip joint stability.
Purpose of the Study:
- To evaluate pelvic shape and innominate bone relationships in unilateral late-diagnosed DDH.
- To identify radiologic parameters indicative of pelvic asymmetry in DDH.
- To explore potential causes of pelvic shape alterations in DDH.
Main Methods:
- Retrospective analysis of 83 unilateral late-diagnosed DDH cases.
- Radiographic assessment of initial anteroposterior pelvic radiographs.
- Measurement of lineal and angular parameters defining pelvic shape and innominate bone relationships.
Main Results:
- Statistically significant differences in pelvic shape parameters were observed in most cases.
- Pelvic asymmetry was a prominent finding in late-diagnosed DDH.
- Asymmetry was more pronounced in cases with negative 'teardrop' values and low hip dislocations.
Conclusions:
- Late-diagnosed DDH is associated with evident pelvic asymmetry.
- Observed pelvic shape alterations resemble those seen in experimental hip dislocation with pelvic deformity.
- DDH-related pelvic shape changes may result from triradiate cartilage growth disturbances.
Abstract:
Eighty-three cases of unilateral late-diagnosed (older than 4 months of age) developmental dysplasia of the hip (DDH) were studied to evaluate pelvic shape and innominate bone relationships in the initial anteroposterior radiograph. To be included, each initial radiograph had to have no lumbar pedicle rotation, lumbar scoliosis, gas shadows, or metallic protectors. Measurements were done using as reference a medial pelvic line, which divides the pelvis into two innominate bones. Lineal parameters were defined to assess pelvic radiologic shape; angular parameters defined the relationship between the ilium, ischium and pubis, and sacrum. Statistically significant differences were observed in most cases, and pelvis asymmetry was evident. The asymmetry was more obvious in cases in which the teardrop had a negative value and in low dislocations. Similar changes have been observed in experimental dislocation of the hip secondary to a triplane pelvic deformity. We suggest that similar alterations of pelvic shape occur in DDH, possibly secondary to growth disturbance in the triradiate cartilage.