Ultrasound hips 7/22/2011
History: 0-day-old girl with positive Ortolani and Barlow maneuver on physical examination. Evaluate for hip dysplasia.
Comment: Coronal and transverse images of both hips were obtained utilizing real-time ultrasonography. Both static and dynamic imaging were obtained, with and without stress maneuvers.
Right hip: At rest, there is slightly less than 50% coverage of the femoral head by the bony acetabular roof. With stress maneuvers, mild increased lateral and slight increased posterior subluxation is elicited. There is significant hip laxity, however in part this is due to patient's age. Right acetabular alpha angle measures 55 to 58 degrees, within normal limits. There is no evidence for acetabular dysplasia.
Left hip: At rest, there is complete posterolateral dislocation of the femoral head relative to the acetabulum. Fibrofatty pulvinar tissue is identified. With abduction maneuvers, there is partial relocation of the left femoral head. There is left acetabular dysplasia, with the left acetabular alpha angle measuring 50 to 52 degrees.
Impression:
Findings consistent with bilateral developmental dysplasia of the hip, with left hip dislocation at rest with associated acetabular dysplasia.
Mild right hip subluxation with stress maneuvers
History: 0-day-old girl with positive Ortolani and Barlow maneuver on physical examination. Evaluate for hip dysplasia.
Comment: Coronal and transverse images of both hips were obtained utilizing real-time ultrasonography. Both static and dynamic imaging were obtained, with and without stress maneuvers.
Right hip: At rest, there is slightly less than 50% coverage of the femoral head by the bony acetabular roof. With stress maneuvers, mild increased lateral and slight increased posterior subluxation is elicited. There is significant hip laxity, however in part this is due to patient's age. Right acetabular alpha angle measures 55 to 58 degrees, within normal limits. There is no evidence for acetabular dysplasia.
Left hip: At rest, there is complete posterolateral dislocation of the femoral head relative to the acetabulum. Fibrofatty pulvinar tissue is identified. With abduction maneuvers, there is partial relocation of the left femoral head. There is left acetabular dysplasia, with the left acetabular alpha angle measuring 50 to 52 degrees.
Impression:
Findings consistent with bilateral developmental dysplasia of the hip, with left hip dislocation at rest with associated acetabular dysplasia.
Mild right hip subluxation with stress maneuvers