Magnetic Resonance Imaging Evaluation of Surgical Management in Developmental Dysplasia of the Hip in Childhood

Utility of magnetic resonance imaging (MRI) after closed reduction of developmental dysplasia of the hip

“…Arthrography is an invasive technique that requires general anaesthesia and articular function. It is widely used before the reduction of a dislocated hip, but it cannot be repeated once the spica is in place [11]. CT scan is responsible for pelvis X-ray exposure and must be avoided in routine practice, especially in young children [7].…”

“…MRI is a superior soft-tissue contrast resolution which allows differentiation between articular structures such as bone, hyaline and fibrous cartilage, ligaments, joint capsule, intra-articular tissues and fluids [14][15][16]. The appearance of the paediatric hip has been widely documented in control patients and in DDH cases [9][10][11][12][13][17][18][19][20][21][22][23][24].…”

“…Magnetic resonance imaging (MRI) has already been used in the determination of the adequacy of the surgical reduction of the dislocation of an immature hip [9][10][11][12][13]. Hip MRI protocols in post-reduction DDH patient assessment provides fast and adequate images without additional anaesthesia requirements or radiation exposure [9][10][11][12][13]. Since 2004, we have routinely used two-dimensional MRI in the coronal and axial planes to evaluate the adequacy of closed reduction of DDH in children.…”

Imaging in the Surgical Management of Developmental Dislocation of the Hip

“…Before ordering a CT, it is important to realize the high radiation burden [9]. It is important to limit the number of CT scans to what is really necessary and to reduce the dosage as much as possible by using a low radiation technique [8,21,38,39].…”

“…Most studies use sedation or anesthesia to prevent motion degradation of the images [9,29]. An abbreviated (average scan time 3 minutes for 2 sequences) scan not requiring sedation in children in a spica cast has been described by Laor et al [25].…”