Complex infantile and congenital hip dislocation: assessment with MR imaging.

Johnson, Neil; Wood, B P; Jackman, Kenneth V.

doi:10.1148/radiology.168.1.3380952

Cited by 32 publications

(7 citation statements)

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“…The normal labrum is roughly triangular, with a laterally down-tilted orientation on coronal images and low signal intensity on both T1- and T2-weighted images. [ 21 ] In contrast, the limbus appears heterogeneous in signal intensity and globular morphology. [ 22 ] In this study, superior limbi with hypertrophy or globular compression by the femoral head, intermediate or mixed MRI signal intensities, and blunted edges were observed.…”

Section: Discussionmentioning

confidence: 99%

The limbus in developmental dysplasia of the hip

et al. 2021

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This study aimed to describe the shape of the limbus arthroscopically and via arthrogram and magnetic resonance imaging (MRI), and to determine whether it prevents concentric reduction of the femoral head in developmental dysplasia of the hip (DDH). Twelve patients (mean age, 10.2 months; range, 3–31 months) who underwent arthroscopic-assisted reduction for DDH were retrospectively reviewed. Limbus shapes were captured on arthrogram before reduction, after closed reduction, and after arthroscopic-assisted reduction and categorized according to the Miyake classification. On arthrogram, the superior limbus was blocked in 2 hips, inverted in 2, intermediate in 5, and everted in 3 after attempted closed reduction. After arthroscopic-assisted reduction, the limbus was everted in 7 hips and normal in 5. On arthroscopy, in all cases, the limbus appeared as a whitish, cartilage-like ring with a variably blunted edge before reduction, without inversion or eversion. On postoperative MRI, 10 of 12 superior limbi showed hypertrophy or globular compression by the femoral head with intermediate or mixed MRI signal intensities and blunted edges. The remaining 2 hips had hypertrophied superior limbi with sharp edges. On transverse plane MRI, the posterior limbus of all hips showed sharp margins with low MRI signal intensity. Residual subluxation was observed in 7 of the 12 hips with interposition of the anteroinferior limbus. The appearance of the limbus varied according to the femoral head position, and it was neither inverted nor everted. Interposed anteroinferior limbi with residual subluxation suggest impeded concentric reduction in DDH.

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Section: Discussionmentioning

confidence: 99%

The limbus in developmental dysplasia of the hip

et al. 2021

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“…By MRI scan, it becomes more straightforward to evaluate the acetabulum and femoral head; describe the anatomical condition of the hip; observe the soft tissues around the articular cartilage, glenoid labrum, round ligament, and iliopsoas to determine if they are associated with joint effusion or adipose hyperplasia; thus the observation accuracy of the pathological changes and their correlations of the intra- or peri-articular soft tissues can be improved extensively. [6] The comprehensiveness of scientific disease assessment can be achieved under MRI scan without sacrificing high resolution of the image. On top of that, MRI scan brings no harm to human body, which serves a better reference to DDH clinical work.…”

Section: Discussionmentioning

confidence: 99%

Analysis of acetabulum in children with developmental dysplasia of the hip by MRI scan

Zhou

Lou

et al. 2019

Medicine

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To review the value of acetabular magnetic resonance imaging (MRI) in children with developmental dysplasia of the hip (DDH) of different ages.Eighty-eight medical records of children with unilateral DDH who were diagnosed and treated in our hospital between January 2010 and December 2015 were retrospectively analyzed. The affected hips were put into the case group, and the normal hips were put into the control group. All cases were further divided into 3 age groups: infant (<1 year), 16 cases; young children (1–3 years), 48 cases; and children (3–13 years), 24 cases. The differences of the acetabular depth (AD), the bony acetabular index (BAI), and the cartilaginous acetabular index (CAI) between each group were measured and compared for a linear correlation analysis. At the same time, the distribution of the acetabular cartilage in the anterosuperior, top, and posterosuperior parts (the three parts) from the two groups was measured, respectively.Measurement results from both the case and control groups were as follows: AD was 5.46 ± 2.62 mm and 9.74 ± 2.33 mm; BAI was 33.26 ± 5.49° and 23.50 ± 5.33°; and CAI was 21.04 ± 6.16° and 12.71 ± 4.83°. Differences from the two groups were statistically significant (t = 11.94, 13.78, 9.16, P < .05); BAI and CAI were linearly correlated (r = 0.86, 0.75, P < .05). The AD in infant, young children, and children groups from the case group were 4.26 ± 0.42 mm, 4.79 ± 1.74 mm, and 7.31 ± 2.74 mm, respectively, which was statically significant as well (F = 11.37, P < .05). Under the same grouping criteria, BAI was recorded as 29.04 ± 5.11°, 34.56 ± 4.27°, and 33.12 ± 5.69°; CAI was recorded as 16.62 ± 5.50°, 21.79 ± 6.33°, and 20.91 ± 6.40° separately. There was a linear correlation (r = 0.78, 0.65, P < .05) between BAI and CAI in young children and children groups. The distribution of acetabular cartilage in the above-mentioned three parts from both young children and children groups was statistically significant (P < .05).MRI is a satisfactory imaging modality to children with DDH of different ages for the assessment of AD, BAI, CAI, and acetabular cartilage in multiple locations. It can provide ample imaging reference to clinical evaluation of the acetabulum development in DDH.

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“…The acetabular labrum is a fibrocartilaginous structure located at the acetabular rim that serves to deepen the acetabulum by 20%-50% (3). The normal labrum is roughly triangular in shape, with a down-tilted orientation laterally on coronal images, and demonstrates low signal intensity on both T1-and T2-weighted images (38). In the setting of hip subluxation or dislocation, the labrum may become everted.…”

Section: Labral Inversionmentioning

confidence: 99%

MR Imaging in Postreduction Assessment of Developmental Dysplasia of the Hip: Goals and Obstacles

Rosenbaum

Servaes

Bogner³

et al. 2016

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Developmental dysplasia of the hip is a spectrum disorder of hip development that ranges in severity from abnormal acetabular morphology to complete hip dislocation. While treatment with a Pavlik harness is highly effective in infants younger than 6 months, older infants and children and those with orthotic failure often warrant surgical reduction and placement of a spica cast, which limits subsequent imaging evaluation. Magnetic resonance (MR) imaging has been described in the evaluation of the adequacy of hip reduction for more than 2 decades, but the practice is still not widespread and is performed routinely at relatively few centers. MR imaging is a robust tool for outcome assessment after hip reduction and placement of a spica cast, facilitating multiplanar confirmation of concentric reduction independent of an ossific nucleus or orthopedic hardware. Excellent image contrast of soft tissues allows identification of obstacles to concentric reduction, which may be extra-articular or intra-articular. Extra-articular obstacles include tightening of the adductor muscles and tightening of the iliopsoas tendon with constriction of the joint capsule. Intra-articular obstacles include limbus formation, labral inversion, an enlarged pulvinar, and hypertrophy of the ligamentum teres and/or the transverse acetabular ligament. Intravenous contrast material administration may demonstrate altered epiphyseal blood flow and help identify patients at risk for early ischemia. Imaging technique and image interpretation can be optimized to facilitate the performance of postreduction MR imaging studies where they may be of benefit. (©)RSNA, 2016.

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Complex infantile and congenital hip dislocation: assessment with MR imaging.

Cited by 32 publications

References 0 publications

The limbus in developmental dysplasia of the hip

The limbus in developmental dysplasia of the hip

Analysis of acetabulum in children with developmental dysplasia of the hip by MRI scan

MR Imaging in Postreduction Assessment of Developmental Dysplasia of the Hip: Goals and Obstacles

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