MRI of Abnormalities of the Hip

134 Pages·2016·7.04 MB·English

by  Patrick Bibbins

Growth Disturbances and Morphologic
Abnormalities of the Hip in Children
Sarah D. Bixby
Department of Radiology
Boston Children’s Hospital
Boston, MA
1
Overview
• Radiographic techniques
• Normal anatomy
• Conditions characterized by growth disturbance
– Acetabular dysplasia
– FAI
– Acetabular protrusio
– Acetabular rim syndrome

2
Imaging the Painful Hip
• Plain radiographs of pelvis and
bilateral hips
– 2 orthogonal views (AP and
lateral)
• Frog-leg
• Cross-table
• Dunn
• False Profile
3
Lateral Hip Radiographs
Frog-leg
False Profile
Dunn Cross-table
4
Lateral Hip Radiographs
• Frog-leg:
SCFE, LCP, femoral head
lesions, screening
• False Profile:
DDH, Pincer
impingement Frog FP
• Cross-table:
Femoral neck lesions
and fractures
• Dunn:
Cam-type femoroacetabular
impingement (FAI)
Dunn CT

5
Femoral Head Coverage
• Deficient coverage
– Acetabular dysplasia
• Instability
• Excessive coverage
– Acetabular protrusio
– Pincer type (FAI)
• Limited ROM
Too little Too much
6
Femoral Head Coverage
Too Little Too Much
Steppacher SD et al. Osteoarthritis and Cart 2014;22:951-958
7
Anatomic Considerations
8
Proximal Femoral Physis
5 year old female 3 week old male
9
Femoral growth arrest lines
10