Assessment of irreducible aspects in developmental hip dysplasia by magnetic resonance imaging

Abstract

Background: The developmental dysplasia of the hip (DDH) can cause a wide range of pathological changes, and often requires surgical treatment. Preoperative evaluation is very important for DDH. We aimed to assess the diagnostic capability of magnetic resonance imaging (MRI) for irreducible aspects preventing hip reduction in DDH. Methods: A total of 39 pediatric patients who received DDH evaluation in pediatric orthopedics from January 2015 to December 2019 were included. The samples included 4 cases of bilateral DDH and 35 cases of unilateral DDH, a total of 43 hip joint samples. All patients underwent surgical treatment, pathological examination and MRI of hip joint.Results: With pathological results or intraoperative findings as the gold standard, the sensitivity and specificity of MRI were 90.3% and 83.3% for the affected labrum, 92% and 83.3% for thickening of the round ligament, 90.0% and 91.3% for atrophy of the iliopsoas muscle, and 100% and 100% for fibrofatty pulvinar tissue and joint effusion, respectively. Conclutions: The MRI showed an extraordinary capability of detecting these irreducible factors and helped surgeon choose the appropriate treatment strategies.

Docking Phenomenon and Subsequent Acetabular Development after Gradual Reduction using Overhead Traction for Developmental Dysplasia of the Hip over Six Months of Age

“…1,2 MRI can clearly detect these abnormalities in all of bony, cartilaginous and soft-tissue structures without radiation exposure and hence is increasingly being used to assess the quality of hip reduction in infantile DDH. [1][2][3][4] Gradual reduction (GR) using traction followed by spica casting is one of the non-surgical procedures for hip dislocation in infant and toddler. Several researchers have reported that GR using traction reduces the failure of reduction and the risk of avascular necrosis of the femoral head while having a slightly higher rate of residual acetabular dysplasia, compared with closed reduction (CR) by manual manipulation.…”