Computed tomography (CT) has been shown to be useful in evaluation of the intracranial lesion. But now, computed tomography has been appealing as a new radiologic modality applicable to diagnosis and treatment in orthopaedic surgery. The two-dimentional picture, in one tomographic cut of any part under investigation, was able to increase the sensitivity or resolution of detection of lesion and able to overcome the disadvanages of conventional roentgenography. Eighteen patients who injuried pelvic fracture were examined by computed tomography after evaluated by plain radiography and occasionally by standard tomography. In six cases, we get a new additional diagnosis which are not found in conventional radiography. We have found that CT was more sensitive than plain radiography in detecting the sacroiliac joint injury and its around structure injury and hip joint integrity. Of more importance, clinical sign and symptom are valuable in diagnostic process.
Diagnosis ; Hip Joint ; Humans ; Radiography ; Sacroiliac Joint

Secondary osteoarthritis of hip joints is a common disease and is frequently followed by chronic sublexation and dislocation. Twenty four case of the secondary osteoarthritis associated with chronic subluxation and dislocation of the hip joints were evaluated with plain radiography and computed tomography. We retrospectively analyzed 1) the ossification and calcification of the acetabular labrum, 2) the thickeness of the quadrilateral plate of the ilium, and 3) anteroposterior diameter of the acetabulum. The changes of the hip joints in subluxation (n=14) revealed ossification of the acetabular labrum in 12 cases (86%), thickening of the quadrilateral plate of the ilium in 11 cases (78%) but anteroposterior diameter of the acetabulum was not changed. The changes of the hip joints in dislocation (n=10) revealed no evidence of the ossification of the acetabular labrum, thickening of the quadrilateral plate of the ilium in 10 cases (100%) and decreased anteroposterior diameter of the acetabulum. We conclude that CT findings of subluxation and dislocation of the hip joints can be helpful in the evaluation of the secondary osteoarthritis of the hip joints.
Acetabulum ; Dislocations* ; Hip Joint* ; Hip* ; Ilium ; Joints ; Osteoarthritis ; Osteoarthritis, Hip ; Radiography ; Retrospective Studies

Computed tomography is helpful in delineating the extent and configuration of pelvic fracture. These injuries are frequently complex, and the precise pathologic anatomy is not easily demonstrated by conventional radiographs. In some case CT will reveal a fracture which may not be seen on the radiograph. In addition, the extent of soft tissue damage and joint involvement is precisely demonstrated with CT. The twenty-three patients admitted to our Inchon Christian Hospital with pelvic fracture with or without hip dislocation from October 1981 to October 1984. We could assess the applicability of C-T scan in pelvic fracture and the following conclusions were obtained. 1. The axial plane of CT was shown to be the most suitable for evaluation of pelvic fracture. 2. C-T could detect the pattern of hip fracture including degree of fracture fragment displacement, and rotation, hip joint stability, intra-articular osseous fragment and interposed soft tissues in hip joint. 2. C-T permitted better evaluation of associated injuries in soft tissue and viscera on the pelvic and retroperitoneal cavity, and also gave information about other associate fractures. 4. C-T was more sensitive than plain radiography in detecting fracture involving the sacrum, quadrilateral surface, acetabular roof, and posterior acetabular hip.
Acetabulum ; Diagnosis ; Hip ; Hip Dislocation ; Hip Joint ; Humans ; Incheon ; Joints ; Pelvis ; Radiography ; Sacrum ; Viscera

BACKGROUND: Total hip arthroplasty (THA) for severe developmental dysplasia of the hip (DDH) is a technically demanding procedure for arthroplasty surgeons, and it is often difficult to reduce the hip joint without soft tissue release due to severe flexion contracture. We performed two-stage THAs in irreducible hips with expected lengthening of the affected limb after THA of over 2.5 cm or with flexion contractures of greater than 30 degrees in order to place the acetabular cup in the true acetabulum and to prevent neurologic deficits associated with acute elongation of the limb. The purpose of this study is to evaluate the outcomes of cementless THA in patients with severe DDH with a special focus on the results of two-stage THA. METHODS: Retrospective clinical and radiological evaluations were done on 17 patients with Crowe type III or IV developmental DDH treated by THA. There were 14 women and 3 men with a mean age of 52.3 years. Follow-ups averaged 52 months. Six cases were treated with two-stage THA followed by surgical hip liberalization and skeletal traction for 2 weeks. RESULTS: The mean Harris hip score improved from 40.9 to 89.1, and mean leg length discrepancy (LLD) in 13 unilateral cases was reduced from 2.95 to 0.8 cm. In the patients who underwent two-stage surgery, no nerve palsy was observed, and the single one-stage patient with incomplete peroneal nerve palsy recovered fully 4 weeks postoperatively. CONCLUSIONS: The short-term clinical and radiographic outcomes of primary cementless THA for patients with Crowe type III or IV DDH were encouraging. Two-stage THA followed by skeletal traction after soft tissue release could provide alternative solutions to the minimization of limb shortenings or LLD without neurologic deficits in highly selected patients.
Adult ; Aged ; Arthroplasty, Replacement, Hip/*instrumentation/*methods ; Female ; Femur/radiography/surgery ; Hip/radiography/surgery ; Hip Dislocation, Congenital/pathology/radiography/*surgery ; Hip Joint/pathology/radiography/surgery ; Hip Prosthesis ; Humans ; Ilium/radiography/surgery ; Male ; Middle Aged ; Orthopedic Fixation Devices ; Retrospective Studies ; Traction

This study was conducted to evaluate the diagnostic utility of magnetic resonance imaging (MRI) for the patients having problems confined to cross-legged posture. The study subjects were 128 cases (male 87.5%) and 120 patients from October 2008 to June 2013. Average age of male patients was 50 years old (range, 21-72 years old), and female 45 years old (range, 18-76 years old). The rate of positive MRI findings was compared according to abnormal physical findings. The average duration of symptoms was 11.7 months. The most frequent complains was on the back (41.9% at rest, 57% when taking the posture). Patrick test was positive for 33.6% of cases, simple radiography was abnormal only for 20% of cases. Bone scan was normal for all 98 cases. Only 21.9% of 128 cases showed abnormal MRI findings which were managed with conservative treatment. Limitation in the range of hip joint motion was not statistically associated with abnormal findings of MRI (p=0.148). Normal Patrick test was associated with normal MRI finding (p=0.001). Among normal cases on both physical and simple bone X-ray film, 88.6% were normal at MRI. In conclusion, for patients with physical complaints from the cross-legged posture, diagnostic utility of MRI is relatively low when they show normal on both physical examination and simple radiography.
Female ; Hip ; Hip Joint ; Humans ; Magnetic Resonance Imaging* ; Male ; Physical Examination ; Posture* ; Radiography ; X-Ray Film

Computerized tomography has been used in the evaluation of the intracranial lesions. Recently the usage of computerized tomography has progressively widened in many fields of clinical practice. In orthopedics computerized tomography has been tried in the diagnosis and the determination of treatment of tumors, spinal disorders, hip disorders and knee problem. Four problem cases in which concentric reduction could not be obtained after closed reduction of hip dislocations were evaluated by computerized tomography from Apr, 1, 1983 to Mar. 31, 1984 in the Capital Armed Forces General Hospital and following conclusiions were obtained: 1. Open reduction revealed that muscles(adductor and pyriformis muscles), joint capsule and osteocartilaginous loose bodies (femoral and acetabular) were interposed to hinder concentric reduction. Large posterior acetabular fragment induced instability and redislocation of the hip. 2. When there were 2-3 mm lack of symmetry of the two femoral heads or any abnormal findings(breakage of Shenton's line etc.) in plain roentgenography, computerized tomography was recommanded, and muscles, osteocartilaginous loose bodies and instability were found. 3. Computerized tomography is an easy simple method and has a great diagnostic value in the evaluation of asymmetry and instability after closed reduction of traumatic hip dislocations.
Acetabulum ; Arm ; Diagnosis ; Head ; Hip Dislocation ; Hip ; Hospitals, General ; Joint Capsule ; Knee ; Methods ; Muscles ; Orthopedics ; Radiography

BACKGROUND: Cotyloplasty is a technique that involves making a perforation of the medial wall of a shallow acetabulum and then inserting an acetabular cup with the medial aspect of its dome beyond the Kohler line. The purpose of this study was to evaluate the results of cementless total hip arthroplasty (THA) using cotyloplasty with focusing on the amount of medial cup protrusion. METHODS: Sixteen hips with insufficient acetabulum in sixteen patients were treated by cementless THA using cotyloplasty. The average patient age was 47 years. The diagnoses included dysplastic hip (12) and infection sequelae (4). All the patients were followed up for at least 2 years. Clinically, the Harris hip scores were assessed and radiologically, the amount of cup protrusion, the hip center movement and cup fixation were evaluated. RESULTS: The average Harris hip score improved from 57 to 94 postoperatively. The average proportion of cup surface beyond the Kohler line was 44.1% and the hip centers were medialized by an average of 23 mm. Stable fixation of the acetabular cup was achieved in all the cases except one. In this one case, migration of the cup was detected 2 weeks postoperatively and a reoperation was performed. CONCLUSIONS: Using cotyloplasty, good coverage of the acetabular cup was obtained without a block bone graft, and the hip joint centers were medialized. However, the safety margin for the amount of protrusion should be established.
Acetabulum/*pathology/radiography/*surgery ; Adult ; Arthritis, Infectious/complications/pathology ; *Arthroplasty, Replacement, Hip ; Female ; Hip Dislocation, Congenital/pathology/surgery ; Hip Joint/radiography ; *Hip Prosthesis ; Humans ; Male ; Middle Aged

In a hip replacement case when a standard hip stem is chosen, it is rough to select hip stems before operation, thus some stand-up standard hip stems should be prepared. The operation time is usually prolonged. In order to solve this problem, this paper presents a method to automatically select optimal standard hip stems by computers. Femoral anatomical data of a patient are acquired from X-ray films. Based on these anatomical data and a database of average cross-sections in proximal femurs, proximal femur of the patient can be reconstructed. This proximal femur model makes it possible to optimally select a standard hip stem. Theory analyses indicate that the method, presented in this paper, is practicable.
Arthroplasty, Replacement, Hip ; instrumentation ; Computer-Aided Design ; Hip Joint ; diagnostic imaging ; surgery ; Hip Prosthesis ; standards ; Humans ; Radiography

PURPOSE: To determine the frequency of diseases of the hip and pelvis, as seen of plain radiography of the lumbar spine in patients with suspicious lumbar disease, and to evaluate the methods used for lumbar spine radiography in Korea. MATERIALS AND METHDOS: Sixty university and training hospitals were randomly selected and asked to describe the projections, film size and radiographic techniques employed for routine radiography in patients with suspected disease of the lumbar spine. Plain radiographs of 1252 patients, taken using 14"x17"film and depicting both hip joints and the lumbar region, were analysed between March 1999 and February 2000. RESULTS: In 15 patients (1.2%), the radiographs revealed hip or pelvic lesions, confirmed as follows: avascular necrosis of the femoral head (n=11, with bilateral lesions in four cases); sustained ankylosing spondylitis (n=2); acetabular dysplasia (n=1); and insufficiency fracture of the pubic rami secondary to osteoporosis (n=1). In 11 of the 20 hospitals which responded, 14"x17"film was being used for lumbar radiography, while in the other nine, film size was smaller. CONCLUSION: Plain radiography of the lumbar spine including both hip joints, may be a useful way to simultaneously evaluate lesions not only of the lumbar spine but also of the hip and/or pelvis.
Acetabulum ; Fractures, Stress ; Head ; Hip Joint* ; Hip* ; Humans ; Korea ; Lumbosacral Region ; Necrosis ; Osteoporosis ; Pelvis* ; Radiography ; Spine ; Spondylitis, Ankylosing

Transient synovitis of the hip in children is a non-specific inflammatory and self-limited condition. It is also the most common cause of painful hip in children under ten years of age. Despite of the benign prognosis, there are many difficulties in distinguishing it from other diseases of the hip joint. It remains a common diagnostic problem for clinician because the clinical symptoms, physical findings, and conventional radiography is not pathognomonic of the condition. The authors paid attention to the increase of effusion in the affected hip and studied the value of the hip ultrasonography in 24 cases of transient synovitis from August 1985 to July 1987. The results are summerized as follows : 1. The ratio of male to female was 7 to 1, average age was 7.9 yrs, average hospitalization period was 4.5 days. 2. In simple X-ray studies, no bony change was detectable except for soft tissue signs in 68% of the cases. 3. Capsule-to-bone distance in sagittal ultrasonographic section revealed abnormal increase in 87.5% of the affected hip. 4. Average capsule-to-bone distance of affected hip joint was 7.50 mm, while that of the normal hip was 4.26 mm. 5. As shown in the above studies, ultrasonography can be considered good noninvasive technique in detection and follow-up of hip effusion. So, it is thought to be a valuable method in the diagnosis of transient synovitis of the hip in children.
Child ; Diagnosis ; Female ; Follow-Up Studies ; Hip Joint ; Hip ; Hospitalization ; Humans ; Male ; Methods ; Prognosis ; Radiography ; Synovitis ; Ultrasonography