Imaging of developmental dysplasia of the hip: ultrasound, radiography and magnetic resonance imaging

Barrera, Christian A.; Cohen, Sara; Sankar, Wudbhav N.; Ho-Fung, Víctor; Sze, Raymond W.; Nguyen, Jie C.

doi:10.1007/s00247-019-04504-3

Cited by 49 publications

(57 citation statements)

References 93 publications

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“…According to our study results, global decreased enhancement of the proximal femoral epiphysis on MRI is a unique imaging marker to predict development of AVN after closed reduction of DDH. The cartilaginous proximal femoral epiphysis shows a speckled or striped pattern of enhancement after intravenous administration of contrast materials on MRI, which represents non-anastomosing vascular canals mainly supplied by medial femoral circumflex artery [23,24]. There were still debate regarding predictive value of contrast enhancement of the femoral head in immediate post op.…”

Section: Discussionmentioning

confidence: 99%

MRI risk factors for development of avascular necrosis after closed reduction of developmental dysplasia of the hip: Predictive value of contrast-enhanced MRI

et al. 2021

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Purpose The purpose of this study was to identify imaging risk factors on contrast-enhanced hip MRI after closed reduction of developmental dysplasia of the hip (DDH) that could predict future development of avascular necrosis (AVN) of the femoral head. Materials and methods Fifty-eight infants (F: M = 53: 5, aged 3–18 months) who underwent immediate postoperative contrast-enhanced hip MRI after closed reduction of DDH were included in this study. Quality of reduction (concentric vs eccentric reduction with or without obstacles), abduction angle of the hip, presence of ossific nucleus, and pattern of contrast enhancement of the femoral head were retrospectively evaluated on MRI. Interobserver agreement of contrast enhancement pattern on MRI were evaluated by two radiologists. Development of AVN was determined through radiographic findings at 1 year after reduction. Results AVN of the femoral head developed in 13 (22%) of 58 patients. Excessive abduction of the hip joint (OR 4.65, [95% CI 1.20, 18.06] and global decreased enhancement of the femoral head (OR 71.66, [95% CI 10.54, 487.31]) exhibited statistically significant differences between the AVN and non-AVN groups (P < 0.05). Eccentric reduction (P = 0.320) did not show statistically significant difference between two groups and invisible ossific nucleus (P = 0.05) showed borderline significance. Multi-variable logistic regression indicated that global decreased enhancement of the femoral head was a significant risk factor of AVN (OR 27.92, 95% CI [4.17, 350.18]) (P = 0.0031). Interobserver agreement of contrast enhancement pattern analysis and diagnosis of AVN were good (0.66, 95% CI [0.52, 0.80]). Conclusion Contrast-enhanced hip MRI provides accurate anatomical assessment of the hip after closed reduction of DDH. Global decreased enhancement of the femoral head could be used as a good predictor for future development of AVN after closed reduction of DDH.

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Section: Discussionmentioning

confidence: 99%

MRI risk factors for development of avascular necrosis after closed reduction of developmental dysplasia of the hip: Predictive value of contrast-enhanced MRI

et al. 2021

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“…There are also published reports on dynamic techniques. 19 , 20 In our clinical practice, we also employ dynamic ultrasound examination in hip abduction, adduction, flexion and rotation, in order to examine whether containment is at risk. The rare clinical finding of ‘hinge abduction’ is easily confirmed by a dynamic examination.…”

Section: Discussionmentioning

confidence: 99%

Ultrasound as a diagnostic tool for femoral head containment disorders in children between one and 12 years of age

Berger-Groch

Jandl

Strahl

et al. 2021

Journal of Children's Orthopaedics

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Purpose Ultrasound has been used to diagnose hip dysplasia in neonates and to screen until the end of their first year. For older children, femoral head containment disorders such as developmental dysplasia of the hip, Legg-Calvé-Perthes disease or cerebral palsy are usually diagnosed with plain radiographs. The aim of the present study was to evaluate ultrasound in comparison with radiographic imaging in children up to age 12 years and to determine reference values for sonographic containment parameters. Methods Hip ultrasound and radiographic imaging were acquired on the same day and then compared. As a reference, normal acetabular angle and acetabulum head index were determined on radiographs. Lateral cartilage distance (LCD), lateral head distance (LHD) and femoral head extrusion angle (HA) were measured on ultrasound images. Results We included 96 patients with 167 healthy hips in the study. A total of 55 patients were female and 41 male. The mean age was 5.2 years (sd 3.3; 1.0 to 11.9). LCDultrasound, LHDultrasound and HAultrasound correlated significantly with radiographic parameters. The following ultrasound values were calculated as limits for impending loss of containment: LCDultrasound ≥ 6.5 mm, LHDultrasound ≥ 3.3 mm and HAultrasound ≥ 27.6°. Conclusion Ultrasound is a simple, radiation-free diagnostic tool to detect femoral head containment disorders, even in children older than one year. This study provides reference values for hip ultrasound in children up to 12 years. Level of evidence III

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“…The most common and serious complication of DDH in the population is hip OA, and when the disease makes progress towards end-stage, the THR is required [11,12]. Therefore, the most essential thing is the early diagnosis and early intervention to delay the progression of OA and thus reduce the likelihood of surgery.…”

Section: Complicationsmentioning

confidence: 99%

“…For DDH after diagnosis, there are different treatment methods at different ages, and it is required for the orthopaedic doctor to grasp the dynamic development process of DDH in detail in order to respond in a proper way. The DDH, which was not found early, is closely linked to adult osteoarthritis(OA) [11], at the same time one-third of hip replacements in adults under the age of 60 are caused by DDH [12]. Therefore, DDH has attracted much more scholars from all over the world.…”

Section: Introductionmentioning

confidence: 99%

Bibliometric Evaluation and Hot Spot Analysis of Developmental Dysplasia of the Hip

Fan

Zhang

Guan

et al. 2020

Preprint

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Purpose: To analyze the research development process and research hotspots of DDH in order to guide the future research direction.Methods: Using the Web of Science database to search the relevant English literatures of DDH from 1994 to May 31,2020 and analyze them with Bibliometric analysis methods. The statistics and the analysis of the collected publications are for the sake of hierarchical refinement and quality assessment of the publications of different countries, authors, institutions, funding agencies, and journals. Using the VOS viewer software for visual conversion and researching direction and important fields of DDH simultaneously.Results: With a total of 2156 articles, the numbers of DDH published articles is increasing steadily. In funding agencies, the National Natural Science Foundation of China has funded most of the researches. In journals, the published articles of JOURNAL OF BONE AND JOINT SURGERY AMERICAN VOLUME are of the highest quality. For authors, KIM YJ is the author who not only published most of the articles, but also published the ones of the highest quality. In countries, the USA is ahead in the quantity and quality of published articles. In institutions, the published articles of UNIV BERN are of the highest quality. Through co-occurrence analysis, it can be seen that the research direction in the DDH field consists of four categories: Diagnosis, Complications, Hip replacement, and Staging treatment before hip replacement. Current research hotspots are mainly focused on treatment.Conclusions: At present, arthroplasty and osteotomy are research hotspots in recent years. It is recommended that researchers start the study of DDH from osteotomy, trying to optimize the adaptation age of various osteotomy to DDH and reduce its complications.

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Imaging of developmental dysplasia of the hip: ultrasound, radiography and magnetic resonance imaging

Cited by 49 publications

References 93 publications

MRI risk factors for development of avascular necrosis after closed reduction of developmental dysplasia of the hip: Predictive value of contrast-enhanced MRI

MRI risk factors for development of avascular necrosis after closed reduction of developmental dysplasia of the hip: Predictive value of contrast-enhanced MRI

Ultrasound as a diagnostic tool for femoral head containment disorders in children between one and 12 years of age

Bibliometric Evaluation and Hot Spot Analysis of Developmental Dysplasia of the Hip

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