Welton K Linnea, Kraeutler Matthew J, Garabekyan Tigran, Mei-Dan Omer
MultiCare Orthopedics & Sports Medicine, Auburn, Washington, USA.
Houston Methodist Hospital, Department of Orthopedics & Sports Medicine, Houston, Texas, USA.
Orthop J Sports Med. 2023 Feb 28;11(2):23259671231152868. doi: 10.1177/23259671231152868. eCollection 2023 Feb.
As knowledge about the origin and morphologic characteristics of hip pain in the young adult has evolved, so too has the clinician's ability to assess for various pathologies of the hip on radiographs, magnetic resonance imaging (MRI)/magnetic resonance arthrography (MRA), and computed tomography (CT). Because there is no algorithm at this time directly indicating what to do in more subtle hip morphologies, such as microinstability and borderline hip dysplasia (BHD), a skilled hip preservation specialist must use multiple imaging sources and know how to interpret them correctly. Imaging parameters used in the workup for hip dysplasia and BHD include the lateral center-edge angle, Tönnis angle, iliofemoral line, and presence of an upsloping lateral sourcil or everted labrum, among many others. The purpose of this narrative review was to detail various established criteria and parameters on anteroposterior pelvis plain radiographs, MRI/MRA, and CT that assist in defining the nature and severity of instability present in a dysplastic hip, thereby aiding in the development of patient-specific surgical treatment plans.
随着对年轻成人髋关节疼痛的起源和形态学特征的认识不断发展,临床医生在X线片、磁共振成像(MRI)/磁共振关节造影(MRA)和计算机断层扫描(CT)上评估髋关节各种病变的能力也在不断提高。由于目前尚无直接表明在更细微的髋关节形态(如微不稳定和临界髋关节发育不良(BHD))中该如何处理的算法,因此,一位经验丰富的髋关节保留专家必须使用多种影像学检查方法,并知道如何正确解读这些检查结果。用于评估髋关节发育不良和BHD的影像学参数包括外侧中心边缘角、Tönnis角、髂股线以及是否存在上斜的外侧眉弓或翻转的盂唇等。本叙述性综述的目的是详细介绍前后位骨盆平片、MRI/MRA和CT上的各种既定标准和参数,这些标准和参数有助于确定发育不良髋关节不稳定的性质和严重程度,从而有助于制定针对患者的手术治疗方案。