Hips are very important for stability and handle a lot of tensile force
Unfortunately dysplastic hips don’t have complete coverage of the joint which can lead to extra stress, labrum tears as well as cartilage loss.
To fix dysplastic hips, there are many surgical or physiotherapy options and a lot of these are guided by advanced imaging. We routinely do 3D segmentations for CTs of the hips 👇
Frontal 3D re-con can also eval for pelvic tilt. Normal values: Men - 2-3mm; Women - 3-4mm
Also look at the up-sloping acetabulum roof, a finding commonly seen in hip dysplasia
The first measurement is the Tonnis angle with normal values 4-10 degrees. Great values suggest dysplasia and lower suggests overcoverage.
Then is the center edge angle with normal values 25-39 degrees. 20-25 is borderline, 15-20 is mild, less than 15 is moderate to severe dysplasia. Greater than 39 is over-coverage.
We move to AP center edge angle, where 20-40 degrees is normal. Greater than 40 is overcoverage and less than 20 is under coverage
Another important measurement is the neck shaft angle with normal 120-140. Less than 120 is Coxa Vara and greater than 120 is Coxa Valga
The second last is acetabular version, but the pelvic tilt angle is measured before measuring acetabular version
Measuring the pelvic tilt angle👆allows us to correct for acetabular version👇
And finally femoral version. We measure knee angle first at the level of the femoral condyles👇
And then use it to correct for femoral version below
Not just #MR and #CT, we routinely do complex (and simple) procedures using #ultrasound, like this #barbotage we performed for a young patient who had immediate pain relief.
We also collaborate closely with @UTSWNeurology@UTSWNeurosci for advanced imaging of complex clinical conditions, like this normal and abnormally thickened occipital nerve for patients with occipital neuralgias
Among the many unique features of our department is how closely we work with our @utswortho family. Check out this case using T2 Dixon imaging, one of the most advnaced MR techniques that is routine at @UTSW_MSK @UTSW_Radiology with corresponding surgical images
Bilateral patellar mal-alignment, seen on radiograph
Notice bony avulsion of MPFL, also seen on T2 Dixon opposed phase which was confirmed on arthoscopy!