Learning objectives
To be familiar with the most useful radiographic measurements of the hip used to detect signs of developmental dysplasia of the hip (DDH) in adults.
To discuss the role of cross-sectional imaging (including CT,
MRI and MR arthrography) in the evaluation of developmental dysplasia of the hip (DDH) in adults and illustrate the main radiologic findings.
Background
Developmental dysplasia of the hip or DDH (also called congenital hip disease),
is a spectrum disorder characterized by an underdeveloped or shallow and upwardly sloping acetabulum (acetabular dysplasia) with decreased coverage of the femoral head,
ranging from mild forms to complete hip dislocation.
It may be associated with varying degrees of morphologic abnormalities of the proximal femur such as excessive femoral anteversion,
coxa valga or femoral head-neck deformity (cam deformity).
It is important to remark that hip dysplasia is not always due to DDH.
Normal...
Findings and procedure details
1.
Radiographic assessment of hip dysplasia in the mature adult pelvis
Radiographic technique
Conventional radiography is the initial step in evaluating etiology of hip pain in any patient.
Hip morphology can be entirely assessed with six views: anteroposterior (AP) pelvic view,
cross-table lateral view,
frog-leg lateral view,
a 45º or 90º Dunn view,
and false-profile view; but all of these views are not routinely performed on each patient.
In general,
the AP pelvic and false-profile views provide the most useful information in radiographic assessment of...
Conclusion
Developmental dysplasia of the hip (DDH) is a well-recognized cause of hip pain and limited function,
leading to premature osteoarthritis in early adulthood.
The diagnosis of Developmental dysplasia of the hip (DDH) in adults can be obvious but sometimes is subtle,
especially in mild forms.
Familiarity with the most useful radiographic measurements used in the evaluation of acetabular dysplasia and the most frequent cross-sectional imaging findings of this condition,
will help us to reach an early diagnosis,
preventing or delaying the development of osteoarthritis.
References
1.
Beltran LS,
Rosenberg ZS,
Mayo JD et al.
Imaging evaluation of developmental hip dysplasia in the young adult.
AJR Am J Roentgenol.
2013 May;200(5):1077-88.
2.
Clohisy JC,
Carlisle JC,
Beaulé PE et al.
A Systematic Approach to the Plain Radiographic evaluation of the young adult hip.
J Bone Joint Surg Am.
2008 Nov;90 Suppl 4:47-66.
3.
Delaunay S,
Dussault RG,
Kaplan PA et al.
Radiographic measurements of dysplastic adult hips.
Skeletal Radiol. 1997 Feb;26(2):75-81.
4.
Jesse MK,
Petersen B,
Strickland C,
Mei-Dan O et...