Article

Imaging Evaluation of Developmental Hip Dysplasia in the Young Adult

1 Department of Radiology, New York University Langone Medical Center and Hospital for Joint Diseases, Room 600, 301 East 17th St, New York, NY 10016.
American Journal of Roentgenology (Impact Factor: 2.74). 05/2013; 200(5):1077-88. DOI: 10.2214/AJR.12.9360
Source: PubMed

ABSTRACT OBJECTIVE. The purpose of this article is to review the clinical and imaging features as well as the potential complications of hip dysplasia in the young adult. Hip dysplasia is an important cause of secondary osteoarthrosis, which accounts for a significant proportion of patients requiring total hip arthroplasty. The radiographic diagnosis of mild hip dysplasia in the young adult may be subtle and is primarily based on the detection of deficient coverage of the femoral head by the acetabulum. CONCLUSION. Cross-sectional imaging, including CT and MRI, afford improved detection and characterization by providing morphologic information about acetabular deficiency. MRI also allows evaluation of potential associated injuries to the articular cartilage, the labrum, and the ligamentum teres. Familiarity with the radiographic and cross-sectional imaging findings of mild hip dysplasia in the young adult may allow a timely diagnosis and implementation of treatment strategies, which may prevent or delay the development of early osteoarthritis.

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    ABSTRACT: The aim of this study was to evaluate the limitations of the Tönnis angle as one of the most commonly used parameters in the diagnosis of acetabular dysplasia, and to explore the feasibility of the modified Tönnis angle in the diagnosis of acetabular dysplasia. A total of 224 patients (120 females and 104 males) with 448 hips, aged between 15 and 83 years (median, 45.0 years), were selected for the measurement of the center-edge (CE) and Tönnis angles. To evaluate the relative position of the medial edge of the acetabular sourcil, a new parameter, known as the center-medial-edge (CME) angle, was designed. As an improvement of the Tönnis angle, a new angle preliminarily termed the modified Tönnis angle was created. In addition, the degree of clarity of the medial edge of the acetabular sourcil on radiograph was evaluated, and the hips were divided into the clear-edge and blurred-edge groups. The hips belonging to the blurred-edge group could not be used for Tönnis angle measurements. All measurements were performed digitally using the tool of the picture-archiving communication system. Among the 448 acetabular sourcils, 142 had a blurred medial edge (31.7%). The mean value of the CME angle was 37.94°, with a range of 21.76-63.99°. The 95% prediction interval of the modified Tönnis angle was estimated to be -6.39 to 11.73°. The correlation coefficients were -0.838 between the CE and Tönnis angles, 0.889 between the Tönnis and modified Tönnis angles and -0.905 between the CE and modified Tönnis angles. In conclusion, the modified Tönnis angle can substitute for the Tönnis angle without joint space narrowing and subluxation of the hip, particularly when the Tönnis angle cannot be measured due to a blurred medial edge of the acetabular sourcil on pelvic radiograph.
    Experimental and therapeutic medicine 12/2014; 8(6):1934-1938. DOI:10.3892/etm.2014.2009 · 0.94 Impact Factor

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