Abstract
BackgroundThe 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.MethodsA 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.ResultsWith 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.ConclutionsThe MRI showed an extraordinary capability of detecting these irreducible factors and helped surgeon choose the appropriate treatment strategies.
Highlights
The developmental dysplasia of the hip (DDH) can cause a wide range of pathological changes, and often requires surgical treatment
The present study aimed to evaluate the capability of magnetic resonance imaging (MRI) for precisely detecting the irreducible mechanisms preventing concentric hip reduction in DDH before surgery, and its applicability in guiding clinical treatment
31 inversed labrum, 31 fibrofatty pulvinar tissue, thickened round ligament, joint effusion, and 20 iliopsoas muscle atrophy were confirmed in the surgeries
Summary
The developmental dysplasia of the hip (DDH) can cause a wide range of pathological changes, and often requires surgical treatment. We aimed to assess the diagnostic capability of magnetic resonance imaging (MRI) for irreducible aspects preventing hip reduction in DDH. DR was commonly applied for diagnosing DDH in patients older than 6 months of age, and the cons is it’s not helpful in identifying secondary intra-articular changes and is associated with the inevitable risk of radiation [10]. Both US and DR are difficult to diagnose preoperatively inverted labrum, hypertrophied ligamentum teres, and shortened iliopsoas muscle
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