Berger-Groch Josephine, Jandl Nico Maximilian, Strahl Andre, Bechler Ulrich, Beil Frank Timo, Stuecker Markus H F
Department of Trauma Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Department of Paediatric Orthopaedic Surgery, Orthopaedic Hospital Bad Bramstedt, Bad Bramstedt, Germany.
J Child Orthop. 2021 Oct 1;15(5):496-502. doi: 10.1302/1863-2548.15.210092.
Ultrasound has been used to diagnose hip dysplasia in neonates and to screen until the end of their first year. For older children, femoral head containment disorders such as developmental dysplasia of the hip, Legg-Calvé-Perthes disease or cerebral palsy are usually diagnosed with plain radiographs. The aim of the present study was to evaluate ultrasound in comparison with radiographic imaging in children up to age 12 years and to determine reference values for sonographic containment parameters.
Hip ultrasound and radiographic imaging were acquired on the same day and then compared. As a reference, normal acetabular angle and acetabulum head index were determined on radiographs. Lateral cartilage distance (LCD), lateral head distance (LHD) and femoral head extrusion angle (HA) were measured on ultrasound images.
We included 96 patients with 167 healthy hips in the study. A total of 55 patients were female and 41 male. The mean age was 5.2 years (sd 3.3; 1.0 to 11.9). LCD, LHD and HA correlated significantly with radiographic parameters. The following ultrasound values were calculated as limits for impending loss of containment: LCD ≥ 6.5 mm, LHD ≥ 3.3 mm and HA ≥ 27.6°.
Ultrasound is a simple, radiation-free diagnostic tool to detect femoral head containment disorders, even in children older than one year. This study provides reference values for hip ultrasound in children up to 12 years.
III.
超声已被用于诊断新生儿髋关节发育不良，并在其一岁末之前进行筛查。对于年龄较大的儿童，股骨头包容障碍，如发育性髋关节发育不良、Legg-Calvé-Perthes病或脑瘫，通常通过X线平片进行诊断。本研究的目的是评估12岁以下儿童超声与影像学检查的对比情况，并确定超声包容参数的参考值。
同一天进行髋关节超声和影像学检查，然后进行对比。以X线平片上的正常髋臼角和髋臼头指数作为参考。在超声图像上测量外侧软骨距离（LCD）、外侧股骨头距离（LHD）和股骨头挤压角（HA）。
本研究纳入了96例患者的167个健康髋关节。其中女性55例，男性41例。平均年龄为5.2岁（标准差3.3；1.0至11.9岁）。LCD、LHD和HA与影像学参数显著相关。计算出以下超声值作为即将失去包容的限度：LCD≥6.5mm，LHD≥3.3mm，HA≥27.6°。
超声是一种简单、无辐射的诊断工具，可以检测股骨头包容障碍，即使是一岁以上的儿童。本研究提供了12岁以下儿童髋关节超声的参考值。
III级。
