J Korean Radiol Soc.  1990 Feb;26(1):160-169. 10.3348/jkrs.1990.26.1.160.

Role of hip arthrography in congenital dislocation of the hip and Legg-Calve-Perthes disease

• Song CJ
• Park CG
• Park CH
• Cho JS
• Kim JC
• Rhee BC

• KMID: 2358993
• DOI: http://doi.org/10.3348/jkrs.1990.26.1.160

Abstract

Hip arthrogram is often requested for both congenital hip dislocation and Leff-Calve-Perthes disease inpediatric age group and has been known as a valuable procedure to evaluate the contour of cartilaginous femoralhead, and the relationship of acetabulum and femoral head, which are not observed on plain film, But, arthrogramis an invasive study, and we have experineced a number of confusions for its role in taking care of patientsinvolved in congenital dislocation of the hip and Legg-Calve-Perthes disease. For this reason, centered on itssignificance in determining treatment plan and predicting prognosis, we retrospectively reviewed 41 arthorgrams in36 patients; 16 arthrograms of congenital dislocation of the hip in 13 patients and 25 arthrograms inLegg-Calve-Perthes disease in 23 patients, which were performed at Department of Diagnostic Radiology, College ofMedicine, Chungnam National University, from January 1985 to May 1989. The results were as follows. 1. Congenitaldislocation of the hip 1) Under the fluoroscopic control we evaluated the possibility of closed reduction afterinjection of contrast media into the joint capsule and if closed reduction was not successful, obstacles to closedreduction were observed. As a result, failure of closed reduction was appreciated in 12 cases of 16 patients andinhibiting factors of closed reduction were as follows; hypertrophied, inturned acetabular lumbus; 12 cases,transverse acetabular ligament thikening; 10 cases, ligament teres thickening; 8 cases, iliopsoas musclethickening; 8 cases, capsular adhesion; 7 cases, other space occupying lesions such as fatty and/or fibroustissue; 9 cases. 2) Hip arthrogram was an excellent method to evaluate the possibility of success of closedreduction and to find inhibiting factors of closed reduction before open reduction. 2. In Legg-Calve-Perthesdisease Hip arthrogram was an useful means to evaluate deformity of irregularity of cartilaginous femoral head,enlargement and lateral extrusion of femoral head, and incongruity of hip joint, but it was not satisfactory todetermine treatment plan and to predict prognsis based on its findings during process of disease.

MeSH Terms

Acetabulum
Arthrography*
Chungcheongnam-do
Congenital Abnormalities
Contrast Media
Dislocations*
Head
Hip Dislocation, Congenital
Hip Joint
Hip*
Humans
Joint Capsule
Legg-Calve-Perthes Disease*
Ligaments
Methods
Prognosis
Retrospective Studies
Contrast Media