Transinguinal sonographic determination of the position of the femoral head after reposition and follow-up in a spica cast.
BACKGROUND
Transinguinal sonography can be used to demonstrate the position of the femoral head after reduction of a dislocated hip.


OBJECTIVE
To determine whether transinguinal sonography can replace radiography and CT in the follow-up after reduction of a hip dislocation?


METHODS
Thirty-three children with 39 dislocated hips were followed up with sonography after reduction and immobilization in a spica cast. In cases of an abnormal position a CT scan was advised. A pelvic radiograph at the end of treatment served as an indicator that no dislocations were missed during the previous sonographic examinations.


RESULTS
The repositioned hips were examined on 138 occasions. Twenty-four examinations were abnormal and CT scanning was performed on 11 occasions. In four children additional CT was done because a recurrent dislocation was suspected or because sonography was difficult to perform. No dislocations were demonstrated. In five children a recurrent dislocation was suspected, on one or more occasions. In all but one child a CT scan was performed that confirmed the dislocation.


CONCLUSIONS
Transinguinal sonography is well-suited to demonstrate a normal position of the femoral head in a spica cast. Transinguinal sonography decreases the number of radiographs and CT scans and reduces the exposure to ionizing radiation.
Beek
Frederik J A
FJ
Department of Radiology, Wilhelmina Children's Hospital, University Medical Centre Utrecht, E.01.231, Heidelberglaan 100, 3584 Utrecht, The Netherlands. e.beek@umcutrecht.nl
Nievelstein
Rutger-Jan
RJ
Pruijs
Hans E
HE
de Jong
Pim A
PA
Sakkers
Ralph J B
RJ
D002370:Casts, Surgical; D002675:Child, Preschool; D005260:Female; D005270:Femur Head / Q000000981:diagnostic imaging* / Q000601:surgery*; D006617:Hip Dislocation / Q000000981:diagnostic imaging* / Q000601:surgery*; D006801:Humans; D007223:Infant; D007264:Inguinal Canal / Q000000981:diagnostic imaging*; D008297:Male; D011379:Prognosis; D016896:Treatment Outcome; D014463:Ultrasonography