![]() ![]() A straight line drawn through the shaft of the femur (dashed white line) usually intersects some part of the acetabulum normally. It falls in the outer quadrants for both hips. The capital femoral epiphysis (blue circles), not yet ossified, should normally lie in the lower inner quadrant formed by the intersections of Hilgenreiner's and Perkins' lines. The two vertical lines (red) are Perkins' lines. The yellow line is the Hilgenreiner line. If not effective or child older than 6 months, closed reduction may be performedīilateral Hip Dislocation.Children younger than 6 months with instability upon examination are treated with a form of bracing.Three-dimensional reconstructions showing the anatomy of the hip joint and shape of the acetabulum can be helpful. ![]() Disruption of Shenton line indicates presence of some degree of hip subluxation It should create smooth arc that is not disrupted. Shenton line is drawn from medial aspect of femoral neck to inferior border of pubic rami. Typically, this angle decreases with age and should measure less than 20° by 2 years of age. Acetabular index is angle between Hilgenreiner line and line drawn from triradiate cartilage to lateral edge of acetabulum. Proximal medial femur should be in lower medial quadrant, or ossific nucleus of femoral head, if present (usually observed in patients aged 4-7 months), should be in lower medial quadrant. Next, lines are drawn perpendicular to Hilgenreiner line through superolateral edge of acetabulum (Perkin line), dividing hip into 4 quadrants. From anteroposterior radiograph of hips, horizontal line (Hilgenreiner line) is drawn between each triradiate cartilage. Typical radiographic evaluation of developmental dysplasia of hip (DDH). The following illustration and description of the measurements comes from Medscape (see citation below).Conventional radiography – using a standing or supine AP view of the pelvis.Ultrasound may be performed with measurement of the alpha angle (greater than 60degress considered normal) and beta angle (less than 55 degrees considered normal).Bilateral dislocations may manifest with a waddling gait.Galeazzi sign – at 3-6 months, dislocated leg appears shorter than the other with the child supine with knees flexed.Ortalani click – is more of a clunk when the when the hip reduces into the acetabulum, with the hip in abduction.10X more frequent in children whose parents had DDH.Lower prevalence in Chinese and black populations.Higher prevalence in Native Americans and Laplanders.It may be associated with ligamentous laxity of the hip, but this is not likely to be the sole reason for its occurrence.Also called congenital hip dislocation/dysplasia. ![]()
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