Transinguinal sonographic determination of the position of the femoral head after reposition and follow-up in a spica cast

Pediatr Radiol. 2010 Nov;40(11):1794-9. doi: 10.1007/s00247-010-1726-3. Epub 2010 Jun 16.

Abstract

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?

Materials and 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.

Conclusion: 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.

MeSH terms

  • Casts, Surgical*
  • Child, Preschool
  • Female
  • Femur Head / diagnostic imaging*
  • Femur Head / surgery*
  • Hip Dislocation / diagnostic imaging*
  • Hip Dislocation / surgery*
  • Humans
  • Infant
  • Inguinal Canal / diagnostic imaging*
  • Male
  • Prognosis
  • Treatment Outcome
  • Ultrasonography