Roentgenography of congenital dislocation of the hip.

The chronically dislocated hip of a 15-month-old girl was studied postmortem. The cartilaginous components of the pelvis (both true and false acetabula) and proximal femur were demonstrated roentgenographically and correlated with gross anatomical observations. These findings should be useful in the interpretation of radiographs in congenital hip dysplasia in children.     

Use of computed tomography in congenital dislocation of the hip

The diagnosis of congenital dislocation of the hip is easily made on plain film; however, after the patient is placed in a spica cast with abduction, plain films and even tomograms often fail to show the position of the capital femoral epiphysis. The usefulness of computed tomography in the clinical setting is described by a sample case. The decreased radiation and increased accuracy of diagnosis should make computed tomographic scanning of the hips the procedure of choice over plain film or tomogram when evaluating congenital dislocation of the hip.     

Ultrasonic investigation of the hip in newborns in the diagnosis of congenital hip dislocation: classification and results of a screening program

Summary The method of ultrasonic examination of the hip is described, the latest updated Graf classification is explained, and the results of a prospective screening program are described. One thousand four hundred and sixty newborn infants were examined by ultrasound and clinically by independent observers. The distribution of the ultrasound types was determined. Recommendations are given for the use of ultrasonic investigation of the hip for groups at risk in the neonatal period.     

Streptococcal antigen-induced dislocation and dysplasia of the hip in newborn rats. Radiologic and histologic evaluation of a model of congenital dislocation of the hip

Dislocation of the hip developed in 62% of newborn rats with streptococcal antigen-induced synovitis. Age at the time of the induction of synovitis is critical since dislocation is not observed in older rats. Synovitis with distention and laxity of the joint capsule is most likely responsible for the hip dislocation. Although congenital dislocation of the hip in children is not mediated by an inflammatory process, the current model of dislocation of the hip in rats is similar in being critically age-dependent, and associated with ligamentous laxity. Our model may be helpful in studying this important clinical entity.     

MRI在婴幼儿先天性髋关节脱位中的应用

目的 探讨MRI在婴幼儿先天性髋脱位的应用价值,为临床提供合理的检查依据.方法 搜集47例3岁以内未经治疗的先天性髋关节脱位患儿行MR髋扫描,全部脱位髋按照Ogden和Dunn的标准分为3类.除Ⅲ型脱位髋外全部髋依照Fisher等描述的方法测量骨性髋臼指数(BAI)和软骨性髋臼指数(CAI)以及骨性髋臼商(BAQ)和软骨性髋臼商(CAQ).结果 正常髋、脱位髋、Ⅰ型脱位髋、Ⅱ型脱位髋的BAI分别是(25.24±3.70) °、(38.12±4.07)°、(35.59±2.86)°、(39.64±3.97)°;CAI分别是(8.49±2.15)°、(17.25±2.41)°、(15.85±2.00)°、(18.08±2.26)°;BAQ分别是0.199±0.026、0.126±0.028、0.131±0.028、0.124±0.028;CAQ分别是0.195±0.027、0.120±0.027、0.120±0.023、0.121±0.030.Ⅱ型脱位髋的BAI、CAI与Ⅰ型脱位髋相比呈升高变化,BAQ、CAQ呈减低变化.经统计分析,测量的 BAI和BAQ分别与CAI和CAQ呈线性相关(r值分别为0.876和0.706).MRI提示CDH主要改变为骨性髋臼失去正常的圆形轮廓,髋臼软骨增生外移.结论 MRI是临床评价婴幼儿髋关节骨、软骨结构和重要软组织的有效方法,是诊断和指导CDH治疗的良好手段.     

Ischemic necrosis of the contralateral hip as a possible complication of untreated congenital hip dislocation

A five-year-old girl with untreated congenital hip dislocation and contralateral ischemic necrosis is described. The ischemic necrosis may have resulted from abnormal stress loading due to the abnormal contralateral hip.     

Arthrography of the hip in the diagnosis of prosthetic dislocation. Method and results

The authors had first experiences of hip arthrography in prostheses loosening in 1967. Now they explain the results obtained in 51 cases, aknowledging the limits of such a method in a few cases, but generally accepting the value of it for correct therapeutic choices.     

髋关节囊法早期诊断先天性髋关节脱位

1 资料和方法 1.1资料 150名均为本院经临床检查疑似患儿,年龄2个月～1.5岁. 1.2诊断方法 1.2.1关节囊诊断方法在X线平片上观察围绕髋关节间隙外密度稍大的半球形关节囊,正常为半弧形,其上缘与髋臼上缘相接.诊断时,于平片上弧形影的下缘(相当于大小转子上缘斜行连线的交点处)向髋臼顶方向做弧形延伸线,正常时弧形规整.     

Complex infantile and congenital hip dislocation: assessment with MR imaging

Twenty-five magnetic resonance hip studies were performed on 19 infants with congenital hip dislocation. These patients had a poor initial treatment response, a teratologic dislocation, or a late presentation. Detailed images of single hips obtained with small surface coils resulted in excellent visualization of all the clinically important soft-tissue and cartilaginous structures of the hip. No other imaging modality demonstrates all of these structures simultaneously.     

Assessment of congenital hip dislocation with real-time ultrasound: a pictorial essay

Real-time ultrasound (US) is the imaging method of choice for diagnosis and follow-up of congenital dislocation of the infant hip (CDH). Clinical aspects and the role of imaging are reviewed. Technique and anatomy, both normal and abnormal, are illustrated, as well as, the use of sonography during treatment with Pavlik harness and spica cast. Correlation of ultrasound findings with clinical examination, other available imaging studies and long-term patient follow-up shows 100% sensitivity and 100% specificity for real-time US diagnosis of CDH.     

髋关节镜在急性髋关节后脱位检查和治疗中的应用

目的 探讨髋关节后脱位急性期行髋关节镜检查和治疗的临床疗效. 方法2005年8月-2009年4月,对32例急性髋关节后脱位患者行髋关节镜检查和治疗.其中男26例,女6例;平均年龄38.5岁(23～55岁).全部患者均根据临床症状、体征及常规前后位骨盆摄片或CT扫描证实为髋关节后脱位.镜下观察髋关节内损伤情况,并在关节镜下行关节清理.8例患者Ⅱ期行髋臼骨折切开复位内固定术.根据Sanders评分评价术后髋关节功能. 结果术中发现29例关节腔内有大小不等游离体,3例股骨头圆韧带断裂,12例髋臼盂唇损伤,8例髋臼骨折需Ⅱ期行切开复位内固定术.术中及术后未出现血管、神经损伤.随访时间平均10个月(5～24个月).根据Sanders评分:优23例,良5例,一般4例. 结论髋关节后脱位急性期行髋关节镜检查能够充分评估关节内的损伤情况,进而对关节内游离体、股骨头圆韧带及盂唇损伤进行有效清理.     

Some effects of position on the roentgenographic diagnosis of dislocation at the infant hip

X-ray findings in the examination of the hips in infants depend upon the position of the infant during the examination. Each of three variables of position, (1) pelvic tilt, (2) abduction of the femurs, and (3) external rotation of the femurs, affects the apparent relation but not the real relation between the acetabulum and the femur.     

Congenital hip dislocation. The clinico-echographic correlations

The authors report their experience with US of the hip in 200 children aged 9 days to 8 months. All the children previously were under-gone physical examination. The sonographic study was carried out with Graf's method. The clinical-sonographic correlation proves the utility of US as a screening method able to show early morphological and functional alterations in the hip. US is thus suggested as a valid alternative to conventional methods to use in those cases where either plastering or surgery is required.