![]() It is mainly used for the assessment and follow-up of DDH, diagnosis of slipped capital femoral epiphysis (SCFE) and osteomyelitis, diagnosis and staging of LCPD, diagnosis of radiologically occult traumatic and stress-related bone injuries and tumor staging.īone scintigraphy is indicated when US radiography failed to detect pathology and MR imaging is contraindicated or not available. MR angiography (MRA) with intra-articular gadolinium injection provides a more accurate evaluation of the joint anatomy and pathologies affecting the acetabular labrum and articular cartilage. Its greatest advantage is its ability to accurately demonstrate the presence of bone marrow edema, evaluate for acetabular cartilage and labral abnormalities, and to detect soft tissue inflammation and joint effusion. MR imaging has a great sensitivity for the detection of early hip disorders in pediatric patients. MR imaging is recommended when radiography and US fail to identify a specific disorder. In addition, US-guided aspiration should be performed if high clinical suspicion for septic arthritis (SA) is present. If hip effusion is suspected, US is more sensitive than radiography and should be used first. ![]() It is useful in screening and diagnosing developmental dysplasia of the hip (DDH) in infants, diagnosing bursal and periarticular fluid collections and hip joint effusion, and guiding hip aspiration and injections. Ultrasound (US) is the imaging modality of choice for the evaluation of hip disorders in infants because of the unossified nature of their bony structures. In patients with clinical examination demonstrating an absence of localized disease, bilateral lower extremities radiography is preferred, whereas when a localized disease is detected, AP and lateral unilateral radiography is indicated. Radiography is used in anteroposterior (AP) and frog-leg position views because of the great variability of the hip according to different ages. This allows the comparison between both hips and the detection of bilateral disease. It is preferred to be used by imaging the whole pelvis rather than the hip unilaterally. Radiography is the initial image modality used for the assessment of hip disorder in pediatric patients. Therefore, the main purpose of this article is to provide: (1) up-to-date evidence-based imaging algorithm for diagnosing pediatric hip disorders and (2) overview of imaging spectrum of common pediatric hip disorders with an emphasis on imaging recommendations and guidelines for practicing radiologists and clinicians managing pediatric patients with various hip disorders in daily clinical practice. ![]() To date, there is a lack of evidence-based imaging approach to pediatric hip disorders. ![]() However, clinical and laboratory findings can overlap, making imaging evaluation crucial in the diagnosis. ![]() Clinical history combined with physical examination and laboratory tests help in establishing a differential diagnosis. Establishing an early diagnosis and treatment is crucial to avoid long-term complications such as growth disturbance and degenerative disease. Affected children usually present with nonspecific symptoms such as pain and/or limp. Hip disorders are common in the pediatric population. MR imaging is recommended when radiography and ultrasound fail to identify a specific disorder. Ultrasound is the imaging modality of choice for the detection of joint effusion.ĭevelopmental dysplasia of the hip screening is recommended only to children older than 4–6 weeks with risk factors or abnormal physical examination. ![]()
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