Hip Flashcards
What is the most appropriate radiological modality after plain film for the hip?
US
Is radiological modality indicated for pt. with suspected AVN of the hip:
plain film
What is the pt. position for AP pelvis radiograph?
supine
Male vs. female pelvis differences?
Male: circle, angle < 90
Female: oval, angle > 90
What is a “teardrop”?
summation of shadows of medial acetabular wall
What lines demarcate the anterior and posterior columns of the acetabulum?
iliopubic and ilioischial lines
What position does pt. assume for lateral view of the hip ?
“foreleg view”
supine with leg flexed and abducted
Indication for hip CT?
Severe trauma Fracture alignment Fractures of the sacrum and acetabulum Measure bony alignment Any condition that MRI is contraindicated (remember ultrasound imaging too)
Intra-articular contrast can added
Indications for hip MRI?
Osteonecrosis of the femoral head Marrow abnormalities (transient osteoporosis) Occult fractures/stress fractures Adult sequela of childhood disorders FAI Labral tears Musculotendinous disorders Athletic pubalgia Sacral plexus disorders
MR/arthrography is used most frequently to ID tears of the:
acetabular labrum
What sound head transducer do you use to observe the hip?
linear
lower frequency
2.5-5 MHz
Inlet view
20 degrees caudally
good view of ring configuration of pelvis, posterior displacement of ring, opening of pubic symphesis
Outlet view
20 degrees towards feet
good view of sacrum and crests
Radiograph indicated with suspected stress fx?
conservative mgmnt first
then plain radiograph
3 common developmental pathologies?
Slipped capital femoral epiphysis
Developmental dysplasia of the hip
Legg-Calve-Perthes
SCFE, Slipped capital femoral epiphysis, incidence:
Boys between 12 and 15, girls between 10 and 13 Obesity can increase risk Surgical intervention is pinning Potential complications Deformity of the hip AVN
Incidence of legg-calve-perthes:
The age of diagnosis is usually between 2 and 12 years old
Average age of 6
4 stages of healing in legg-calve-perthes:
Femoral head becomes more dense with possible fracture of supporting bone;
Fragmentation and reabsorption of bone;
Reossification when new bone has regrown; and
Healing, when new bone reshapes.
Treatment of legg-calve-perthes?
Treatment generally conservative
Surgery involves osteotomy, tenotomy
What are the 3 types of developmental dysplasia?
Dislocated
Dislocatable
Subluxatable
Cam lesion
overgrowth on femoral head
maybe pinch or bony end feel into end range flexion
pincer lesion
acetabulum overgrowth
