Hip Sonography: Diagnosis and Management of Infant Hip Dysplasia

Contents......Page 10
1 Technique......Page 12
1.3 Image Projection......Page 13
2 Anatomy and Ultrasound of the Normal Infant Hip Joint......Page 15
2.3 The Proximal Femur in Hip Ultrasound......Page 16
2.4 Femoral Head......Page 17
2.4.2 Ultrasonic Problems and Difficulties with the Nucleus......Page 20
2.4.3 Synovial Fold and Joint Capsule (Fig. 2.7a–d)......Page 23
2.5.1 The Perichondrium of the Hyaline Cartilage Acetabular Roof......Page 24
2.5.2 The Acetabular Labrum......Page 25
2.5.3 The Acetabular Fossa......Page 26
2.5.4 Definition of the Osseous Rim (Fig. 2.12)......Page 27
3 The Standard Plane......Page 28
3.1 The Principle of the \"Standard Plane\"......Page 29
3.2.1 Shape of the Posterior Section......Page 30
3.2.4 Exceptions and Variations on the Typical Sectional Silhouettes......Page 31
3.2.6 The Question of Reproducibility......Page 34
4 Identifying the Anatomy and Checking the Landmarks and Tilting Effects......Page 36
4.2 Checking the Landmarks......Page 37
4.3 Checking a Hip Sonogram......Page 39
5 Definition of Types......Page 40
5.1 Type I......Page 42
5.3 Type III......Page 43
5.5.1 Ossification......Page 44
5.5.3 How to Assess Echogenicity in the Hyaline Cartilage Acetabular Roof......Page 45
6 Ultrasound Classification......Page 47
6.1.1 Basic Terms and Possible Variations......Page 48
6.1.2 Exceptions to the Systematic Description......Page 50
6.2 Systematic Reporting of a Sonogram......Page 51
7 Measurement Technique......Page 52
7.2 Base Line (Fig. 7.2a–c)......Page 53
7.3 Cartilage Roof Line (Fig. 7.3a–c)......Page 55
8 Classification Using the Sonometer......Page 58
8.1.1 Subdivision of the Type II Joint......Page 59
8.2.1 Type Ia and Type Ib Hips......Page 60
8.2.2 Type D Hip......Page 61
8.4 Certainty of the Diagnosis......Page 62
9 Instability......Page 64
9.1 Elasticity \"Elastic Whipping\" (Fig. 9.1.b–d)......Page 66
9.3 Summary of the Principal Differences Between Elasticity and (Pathological) Instability......Page 67
10 The Terminology of Dislocation......Page 68
11 Scanning Technique......Page 70
11.2 Leading and Guiding the Mother......Page 71
11.3.2 Obtaining the Picture......Page 72
11.4 Errors......Page 76
12 Errors Due to Tilting the Probe......Page 82
12.4 Caudo-cranial Tilting......Page 83
12.5 Cradle and Probe-Guiding Equipment (Figs. 11.1c, 11.4b)......Page 84
13 Documentation and Quality......Page 87
13.3 Tips for Checking and Ensuring the Quality of One\'s Own Sonograms......Page 88
14 Principles of Ultrasound-Based Management......Page 89
14.3 Stages of Treatment......Page 90
14.3.3 Retention......Page 91
14.3.4 The Maturation Phase (= Ossification Phase)......Page 93
14.3.5 Maturation Curve......Page 94
14.4.2 The Parental Problem (Compliance Problem)......Page 99
15 Appendix......Page 100