Update on technical aspects of performing DR for imaging the paediatric hip. Review the standard of care for patients presenting for hip screening after 4 months of age. Sensitivity and specificity of DR for detection of hip dysplasia. New developments in paediatric hip imaging.
Developmental disorders of the hip are common in the paediatric population.
The incidence of DDH is 1.5 to 20 per 1,000 births.
Early and accurate detection is important in order to avoid complications and associated morbidity going forward into adult life.
There is currently no consensus on screening for DDH.
Plain radiographs form the mainstay of initial radiographic investigation after three months of age.
Technique Is of vital importance given the variety of clinical presentations and the...
Imaging findings OR Procedure Details
Current practice at our hospital is to peform AP only radigraph after 4 months of age.
In the setting of a specific clinical concern from a paediatrician or orthopaedic surgeon,
additional frog leg views can be added.
Lateral views are reserved for confirmation of suspected SUFE or in other rare clinical circumstances.
Frog leg lateral view can help to determine if a subluxed hip will reduce. Discussion with the radiographer group at our institution raised the suspected concern that there is...
Evidence is variable for the use of frog leg only versus AP only views with suggestion that frog leg views are lower in terms or radiation dose.
A multicentre randomised prospective study should be carried out to determine the most effective way of imaging the paediatric hip. Consenus has not been reached on gonad shielding and potential avenues of tailored gonad shielding or alternate devices are yet to make it to the x-ray department.
This is an exciting area for development. Overall...
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(2009). ACR Appropriateness...