In order to evaluate ultrasonography in patients with suspected hip joint effusions, 123 consecutive patients were examined prospectively. Twenty healthy subjects were used as a control group. The normal sonoanatomy, the recommended scanning approach, and the diagnostic features of intra-articular joint effusions are presented. Even minor fluid collections of 1 or 2 ml could be accurately detected. Transient synovitis and fresh hemorrhagic effusions proved to be echofree, whereas clotted hemorrhagic collections or septic arthritis showed non-echofree effusions. Based on intraoperative and computed tomography (CT) data, ultrasonography is clearly superior to X-ray films in detecting joint effusions. A negative sonogram will exclude a fluid collection; the depiction of an echofree effusion will virtually rule out septic arthritis. The use of additional imaging techniques can be reduced greatly, as ultrasonography seems to be an improved method for the early diagnosis of septic arthritis.

Purpose In this retrospective study we compared the efficacy of ultrasound and radiography for determining the position of the femoral head after closed or open reduction in DDH. Materials and methods The ultrasound was performed using the van Douveren technique by a transinguinal approach through a perineal window of the spica cast. Sixty-eight a.p. radiographs of the pelvis were correlated to 68 ultrasound images. Results Thirty-two radiographs were not useful for precisely determining the femoral head position, whereas the criteria described by van Douveren et al. could be identified in all ultrasound images. All ultrasound images in the study were useful and gave reliable information about the position of the femoral head. Conclusion Consequently, standard radiographic documentation is no longer used as a standard in our clinic. MRI and CT are reserved for special cases. We recommend transinguinal ultrasound as a standard diagnostic method to determine the position of the femoral head in hip spica casts safely and reliably.

Ultrasonography with high resolution technique enables the differentiation of intra- and paraspinal structures in a significant way. Conditions, examination technique, and sonographic anatomy of the os sacrum, the lumbar and dorsal spinal canal as well as the cranio-cervical junction are presented.

The reproducibility of classifications and measurements used in ultrasound of the infant hip has been evaluated in a prospective, double-blind study. Normal values and range distribution are defined for the main types as well as the potential for discriminating these types by means of ROC-analysis. The clinical validity of the method in defining normal and pathologic findings is discussed in comparison with X-ray diagnosis and follow-up sonographic investigations. Visual analysis focussing on a few diagnostic criteria, mainly the inclination of the acetabular roof and the position of the femoral head, provides sufficiently high accuracy (94% agreement rate) and the best diagnostic results. A correct examination which includes tests of the mobility of the hip joint and limitation of the section level to the maximal depth of the acetabular fossa, allows nearly perfect diagnosing of dysplasia and dislocation.