A picture of the hip joint norm

X-ray of the hip joints to a newborn child: is it harmful?

Everyone familiar X-ray room cabinet Problems with the musculoskeletal system are of interest to many scientists and doctors.

Bone-joint and muscular system in children have their own characteristics. For children of an earlier age is characterized by the presence of predominantly cartilaginous tissue, rather than bone.

Because of this, they often show dislocations and subluxations, rather than fractures. This is most clearly seen in children with congenital dysplasia of the hip joint.


Hip dysplasia: symptoms of

Hip dysplasia is commonly referred to as a condition in which there is a certain underdevelopment of the tissues that form the hip joint. Usually dysplasia is considered the initial stage of a dislocation or pre-preening of the hip joint. If you do not help the child in the early stages after the development of the uterus, the risk of disability of the baby increases significantly.

This problem is quite common. According to statistics, dysplasia of the hip joint is present in almost every fourth child, but immediately after birth, spontaneous correction of the dislocated femoral head occurs, and the limb develops normally, without any pathology.


Compare a healthy and sore joint Hip dysplasia involves a mismatch of articular surfaces. It most often develops when, when in the womb of the mother, the baby's legs are brought together( this usually manifests itself in a pelvic presentation of the fetus with the legs crossed).Because of this, the articular surfaces( acetabulum and head of the femur) do not develop in close contact with each other. Even in the norm the hip joint of the child is extremely unstable. This instability is due to the fact that during childbirth for the correct birth of a baby, it is necessary to give him the most advantageous position. This is important for the normal passage of all the limbs of the fetus through the crotch of the mother, so as not to cause a rupture of the vagina. For this purpose, the kid's organism provides for the inferior development of most joints and fontanelles.

With dysplasia of the hip joint, the late development of ossification points is observed. The nuclei are inferior in size to normal, they begin to be visualized on the roentgen much later, and the process of their ossification is prolonged. Visually, with subluxation or dislocation, one can observe a vertical lateral displacement of the ossification nuclei relative to their normal position. Normally, ossification nuclei are observed in girls at about the age of 4 months, and in boys at 6. In some cases, the nuclei may begin to ossify in a later period( in the region of the year).Based on this, it is possible to suspect hereditary metabolic diseases associated with a violation of the metabolism of calcium and other ions in the blood. Congenital dislocation of the limbs can easily be diagnosed in such a situation.

During the birth of a child, development of a dislocation or subluxation is possible. They develop due to the fact that almost completely the hip joint is made with a cartilaginous tissue, and congruence of the articular surfaces is not high.

The head of the femur is excessively large and does not correspond to the size of the acetabulum. The ligamentous apparatus in this region does not possess elasticity, it is easily amenable to displacement and extension. Because of this, the head of the femur can easily leave its articular bed and move to the side, which contributes to the development of dislocation. In very rare cases, dislocation can lead to rupture of the hip tissues, which will require emergency surgical care.

If in the first days of a child's life not to take the necessary measures, the dislocation can be established. This will contribute to the development of the point of ossification in the head of the femur( normally it begins to ossify at the age of 2-3 months), an increase in muscle traction( due to the gluteal muscles that pull up the limb upwards).In this case, a decrease in the relative length of the limb will be observed, and lameness will appear by the year.

With further walking, it is possible to move the femur to the front of the pelvic bone, where the thigh receives a new fulcrum, and walking is further disturbed. If you do not provide assistance and at this stage the child faces a disability and a complete loss of the ability to go straight.


Where to make an x-ray of the hip joint

Modern equipment causes minimal harm to the patient This problem is dealt with not only by pediatric orthopedists, but also by traumatologists, pediatricians, and radiologists. In any private clinic or public hospital, where there is the necessary equipment, you can make an x-ray picture of dysplasia of the hip joints.

In order to prevent the development of the disease, it is necessary to conduct a thorough diagnosis at early stages of the baby's life. It should be composed of general examination data, and also include information obtained from various instrumental studies.

Checking the angle of the newborn In the first months of life to establish the presence of hip dysplasia or dislocation is difficult. This is due to the fact that the child is not walking yet, his muscles are slightly atrophied, which creates the appearance of a normal limb and does not give a visual definition of the length of the limb. The only symptom that can indicate the presence of a dysplasia of the hip joints is the "click symptom".It is characterized by the appearance of a specific sound in the direction of the dislocated limb( in addition, for the disease of dysplasia of the hip joints, a fairly easy and free dislocation of the femoral head and its reverse reposition are characteristic).Frequent adjustment and displacement of the head of the bone can lead to a kind of "joint failure", in which the hip will be able to spontaneously correct and dislocate without the use of large forces. However, this condition occurs in children over the age of the year, in which the capsule and ligaments have already become elastic, and they have contributed to an additional displacement due to their structure.

At the first attempts of the child to crawl and walk this pathology is already easier to determine. Visually, the presence of a dislocation or subluxation can already be determined by a shift in the symmetry of the skin folds. You can already see the discrepancy of the limbs in the length( relative shortening).In the diagnosis, an attempt to dilute the baby's legs can also help. If you pay attention to the legs of the baby during his sleep, you can determine the symptom of the external rotation of the thigh( in the dream, the limb muscles relax, which causes the leg to assume a position that slightly turns outward).Normally, if you take your hips to the newborn, they should lie on the surface of the table. In a more adult child( up to a year), the norm should be about 60 degrees. If from any side it is less than the norm, then it is necessary to suspect the pathology of the joint.


X-ray of the hip joint: the preparation of the infant and the elderly

However, despite the above symptoms, the advantage of diagnosing dysplasia still belongs to X-ray methods. It is they that make it possible to establish a diagnosis of dysplasia or dislocation with an accuracy of about 70%.

Parents often have a question - is it possible to hold a kid with a radiograph of the joints? Is it harmful for the body?

The answer to this question is twofold. On the one hand, it is harmful. Any radiological load on the children's body is extremely unpleasant and can lead to the development of hematological pathology or cancer problems. On the other hand, with competent dosing of radiation, it is possible to detect, with little or no harm to the baby, the problems with the musculoskeletal system available to him( but not the fact that even such a minimum dose of rays will not affect the baby in the future).For infants, especially younger than 3 months, it is desirable to abandon the X-ray study and give preference to ultrasound. As he grows up( up to a year), the child is already allowed to perform an X-ray examination, but only after careful monitoring of the dose of incoming radiation.

It is recommended to use ultrasound to determine the pathology of the joints. From year to year they switch to X-ray diagnostic methods.


Hip Dysplasia: X-ray of the

The screening test confirmed the diagnosis of the baby First of all, it is necessary to pay attention to the position of the child. Normally, a picture of the hip joint should be carried out in the lying position of the baby with the legs straight and extended along the legs. In no case can the limbs be bent in the hip joints, as this will create the prerequisites for a false diagnosis of dysplasia. Another nuance that often manifests itself during the decoding of pictures is the ability to correctly distinguish the pathological location of articular surfaces from the lower limit of the norm.

In newborns, the x-ray of the hip joint is performed in a recumbent position, but with the legs brought to the body and some internal rotation. Taz of the kid at the same time should fit snugly to the cassette so that there are no errors during the recording of the picture. Sexual organs of children should be protected with a special lead apron or plate to prevent damage to the gonads and the development of subsequent infertility or pathology of the reproductive system and hormonal background. It is extremely important to keep the baby during the procedure of an X-ray, as there is not much which child will lie still and wait until the doctors do everything they need. Therefore, to prevent excessive mobility and activity of the baby, it is recommended to put him to sleep before the X-ray procedure, or simply talk calmly with him, sing so that the kid does not get scared and starts moving legs and pens.

Special attention is paid to the main articular structures, such as the acetabulum, the ratio of the head of the femur and the cavity itself, when decoding the image.

Scheme of norm and deviation of the development of the pelvic joint

Diagram of the norm and deviation of the development of the pelvic joint

In order to fully appreciate them, it is recommended to do x-rays in several projections. Everything is complicated by the fact that when creating several pictures, the dose of radiation is significantly increased, because of this it is necessary to immediately put the baby right and prevent his movements, since the repeated snapshot will be extremely dangerous.


X-ray: an example of the diagnostic features of

When carrying out the X-ray procedure, one should keep in mind some features. First of all, that the children in the joints are dominated by the cartilage, and because of this it is not possible to fully visualize the entire joint cavity. For this, certain schemes for the X-ray procedure are being used.

After carrying out the radiography it is extremely important to correctly interpret the main indications. For their interpretation, a special Hilgenreiner's scheme is used. It analyzes the main parameters of the joint in the baby, such as the acetabular angle, the distance from the Hilgenrainer line to the metaphyseal plates( h) and the bottom of the vestibular cavity to h( the value of d).

The acetabular angle is determined between two parallels, a line drawn through the ipsilone-shaped cartilage, and a tangent through the edges of the articular cavities. Normally, this angle in children under 3 months is approximately 30 degrees and, with time( or more precisely, by the year) decreases to 20.

Verification scheme - visual aid The value of h is determined from the horizontal line of the Hilgenrainer to the middle of the metaphyseal plate of the proximal femur. This indicator indicates the displacement of the head of the femur with respect to the acetabulum. Normally, this value is determined on the right and left, while it occupies a span of 9 to 12 cm. Decrease in the indicator or its differences on the right and on the left is the presence of pathology.

The interval from the bottom of the acetabulum to h indicates a lateral displacement of the femoral head relative to the cavity. This figure is equal to both sides and is normally about 15 mm.

The advantage of this scheme is that it gives an idea of ​​the volumetric projection of the joint and allows one to suspect the presence of even the smallest changes in the early stages of the disease. Scheme Hilgenreinera was widely adopted and recognized due to its uniqueness and reliability of interpretation of images.

For more reliable diagnosis, use auxiliary lines. These lines include the lines of Shenton and Calvet. The Shenton line is held as an extension of the acetabulum circle to the medial surface of the femoral neck. This line is broken at the lateral-proximal displacement of the thigh. The Calvet line connects the outer edge of the ilium and the upper edge of the neck of the thigh. When subluxation or dislocation, this arc is interrupted, which allows you to suspect a violation of the integrity of the joint.


Other x-ray charts

Comparison of the healthy and aching pelvic joint

Comparison of healthy and diseased pelvic joint

The following regimens have also become common in the diagnosis of hip dysplasia:

  1. Scheme of Rheinberg. For its use on an X-ray, several lines are drawn: line A, drawn horizontally through the tips of the Y-shaped cartilages and through centers of ossification points in the thighs;A vertical line B is drawn through the supra-lateral protrusion of the acetabulum. In addition, the median sacral line is drawn. The evaluation of the state according to this scheme is carried out in the following way: first of all, the distance between the midline and the line B is estimated. On the basis of the distance between them, a minor line B1 is drawn from the parallel side of the body. When unilateral dislocation, line B is carried out from the side of a healthy limb, and only after that - with the affected one. In the presence of congenital dislocation of the femur, the proximal end of the femur is located above the A line and is located outside of the line B. In addition, such an identification mark as the lower edge of the femoral neck is used. Its contour should normally cross the lower contour of the inguinal bone( its horizontal branch) and make the right line( the Shenton line).
  2. Scheme of Ombredan. A snapshot for the evaluation under this scheme is carried out somewhat vertically. In the image, a horizontal line is visually drawn through the synostosis between the iliac and pubic bone. Vertically perpendicular, which is lowered to the outer edge of the acetabulum. Normally this perpendicular visually divides the joint cavity into 4 quadrants. In each of the quadrants, its components are evaluated( in the lower inner quadrant, the nuclei of ossification of the femoral bone heads should normally be projected).With subluxation, this nucleus is located in the outer lower quadrant, and when dislocated - in the outer upper quadrant.

Other methods of diagnosis

If during the X-ray diagnostics there are no proper results of the study or there is no possibility to fully assess the condition of the joint, it is recommended to resort to CT computed tomography. This method is more informative than conventional radiography, as it allows to more accurately assess the condition of articular surfaces.

Severe abnormality of pelvic development During the procedure, the bone structures are more contrasted and saturated, which, however, is also a minus - it is difficult to mark the border of normal cartilage and not to confuse it with an enlarged articular gap.

If computed tomography does not help, it's best to use arthrography. The method is specifically aimed at the study of joints( in particular articular surfaces and joint space).The method of reliability is on par with the radiography. A full evaluation of the joint, its mechanics allows even to predict the further development of the disease and determine the need for subsequent replacement operations.

Based on X-ray diagnosis, it becomes possible to determine the further treatment plan for the baby. If the deviations from the norm are insignificant, the condition can be corrected by tightly swaddling the child and wearing special structures( for example, Pavlik's stirrups).If the changes are significant, more severe methods of correcting the position of the limbs in the joint may be required( gypsum, board with extension).

In no case should you try to find out inconsistencies of the legs of the baby to fix everything yourself, without consulting a doctor, since you can make a child disabled for the rest of your life.


X-ray diagnostics: contraindications

There are some contraindications for X-ray diagnostics. First of all, it should be noted the problems with the immune system. Immunodeficiency, backed up by X-rays, can contribute to changes in the bone marrow, after which, when curing dysplasia and dislocation of the hip joint, it is necessary to contact hematologists.

Another contraindication to the procedure of X-rays is the predisposition of the baby to oncology( to be precise, then radiation sickness).

Caution should be given to X-rays for children with severe metabolic defects, with poor tissue supply, with obvious atrophy, with already existing problems with bones( juvenile idiopathic osteoporosis).

If possible, it is better to abandon the procedure of X-rays - after all, it's a kid whose organism is extremely susceptible to the effects of X-rays. Do not spoil his health by this method. Agree to it or not - it's up to you, but not always the harm obtained as a result of irradiation, is worth the healing of an innate dislocation.

Based on everything that was said above, it can be understood that X-ray diagnostics for hip dysplasia in children is practically an indispensable method of investigation. Despite all its harmfulness, only an x-ray can give a complete picture of what is happening in the joint and help in determining the treatment. Undoubtedly, it is important and proper styling of the baby, contact during its implementation of the baby with his mother. The main thing is the correct dosage of the radiation dose and the competent arrangement of the baby under the X-ray, and then you can forget about problems with the hip joints forever.

MoiSustav.ru

X-ray of the hip: norms in children and adults, preparation, as performed by

The hip joint X-ray is by far the most common method of examining the human skeleton. Based on his result, the doctor can make a clear and correct decision on how to treat a patient who has problems with the hip joint, and this applies not only to adults, but also to children.

The problem of dyspasia of the hip joint

X-ray of the pelvic bones is considered to be a simple and accessible research method, but due to the fact that it has a harmful effect on the body and poor visualization of soft tissues in the pictures, it is reluctant to practice in pediatrics. It depends on the fact that the baby has up to three months of bone consist of cartilaginous tissue, and that's just badly visible in the pictures. Therefore, he is prescribed to children from the age of three months, and most often used for the study of hip joints is ultrasound.

X-ray of the hip joints in infants is carried out with suspicion of congenital or acquired hip dysplasia. In medical practice, three degrees of this problem are distinguished:

  • dislocation,
  • subluxation,
  • predstaviha.

During prehistory, unlike dislocation, there is such a time when the head loses partial contact with the acetabulum. In this case, there is no displacement of the joint, and only symptoms of bone dysplasia arise. X-ray of the hip joint to children at such an early age is prescribed when diagnosed with delayed development of the joint or its deviation from the norm. Such a problem requires mandatory observation.

The doctor

The sooner the doctor prescribes this type of examination, the better able to help your child with effective treatment.

Treatment will restore the anatomical rate and good functional ability. The first and the main signs of hip dysplasia in infants: a limited hip allocation on the side of the affected area, the asymmetry of the folds on the hips. During the dislocation, the hip is shortened, and if you try to take it aside, you can hear a characteristic click. Another common indication for X-rays in children is hip joint trauma, arthritis, arthrosis, suspicion of neoplasm, other abnormalities.

Where and who appoints the study?

This problem is handled by pediatric orthopedists, traumatologists, pediatricians and radiologists. X-rays to children can be done in a public hospital or private clinic, that is, where there is a special apparatus for this. In order to prevent the development of pathology, it is necessary to undergo a thorough diagnosis in the early stages of a child's life, which includes a full examination. But you can not exclude and instrumental research. Do you need a specific preparation for the procedure?

Preparation for the

procedureSpecial preparation from the patient is not required. A specialist in preparation should prepare a special lead apron, which closes the patient's body from excessive exposure. Despite the fact that many experts for X-rays, mummies are still against it. But lovely ladies, you must understand that X-rays are considered to be an accurate method for diagnosing problems associated with the hip joint and establishes a diagnosis with 70% accuracy.

Carrying out an X-ray

Yes, X-rays are harmful, as the radiological load on the children's body occurs, and further development of hematological pathologies or changes in the cancer profile may occur. But on the other hand, if the expert is competent, he will do the minimum dosage of irradiation, and the procedure will be carried out with a minimum dose of harm for a small patient. Those children who have not reached the age of three months should refuse to conduct such a procedure and give preference to ultrasound examination.

Up to one year of age, an X-ray can be performed, but only with a clear control of the dosage of incoming radiation. But it is better to give preference to ultrasound at this time. And after a year - it's safe to do an x-ray. In the first months of life, the baby is difficult to diagnose dysplasia of the hip joints, since his muscles are still atrophied. The only indicator of the presence of such a problem is a characteristic click.

Principle of the

procedure Before taking an X-ray to a small child, you need to take into account that they have cartilage instead of bones, and therefore it is impossible to fully see the entire joint cavity. In this regard, there are certain schemes. After getting the picture, the doctor needs to make the correct conclusion, for this use the scheme of Hilgenreiner. With its help it is possible to analyze the indices of the joint in the baby, such as the acetabular angle, the distance from the Hilgenrainer line to the metaphyseal plates( h) and the bottom of the vestibular cavity to h( the value of d).

The acebular angle is two parallel lines that pass through the ipsilone-shaped cartilages. In the normal state, this angle is 30 degrees. This indicator refers to children under three months. After three months - reduced to 20 degrees. The value of h, if located incorrectly, can mean the displacement of the head of the hip, in the normal position it should be on a segment from 9 to 12 cm.

If this indicator is less or more, then the child has a pathological process. If the distance from the bottom of the acetabulum to the value of h is not 15 mm, then this also indicates the presence of problems. This scheme allows you to study and give the right conclusion, thanks to it you can suspect the most minor changes and pathologies. For a more accurate study use additional lines of Shenton and Calvet.

Contraindications

  1. Firstly, it is impossible to carry out X-ray diagnostics if the immune system is broken, since it is likely that after this, it will be necessary to turn to hematologists for help, as there will be changes in the bone marrow.
  2. Secondly, if the child has a predisposition to oncological diseases, namely, radiation sickness.
  3. Thirdly, with extreme caution, it is necessary to do X-rays to children who have severe metabolic defects, during poor nutrition of tissues and with obvious atrophy.

If possible, try to abandon the X-ray, because a small body is not really protected from X-rays. Do not spoil his health with this method of diagnosis. The last word, of course, will be for the parents, but it's worth noting that not always the harm is worth the healing of an innate dislocation.

In the end I would like to note that this method of research is considered the main and indispensable for diagnosing joint dysplasia in children. But in spite of the fact that it is harmful, only the x-ray is able to give a clear picture, thanks to which it is possible to determine the correct direction in the treatment.

SpinaZdorov.ru

X-ray of the hip joints - prices, norm, decoding, preparation, contraindications

- aseptic necrosis of the femoral head;

- with suspected development of neoplasms of various genesis( tumors, cysts, metastases to the joint).

Osteoporosis of the hip joint can be detected with X-ray only at a late stage of the disease.

Preparing for radiography

The study requires a preliminary cleansing of the intestine.2-3 days before the X-ray, it is necessary to exclude from the diet products that cause gas formation( carbonated beverages, legumes, black bread, yeast dough, raw vegetables and fruits, beer, etc.).On the eve of the X-ray of the hip joints, you must take a laxative or make an enema. To go on roentgenography follows on an empty stomach.

Before the procedure, it is necessary to remove all metal objects located in the area under examination from the body, clothes.

Contraindications

Radiography of the hip joints is prohibited during pregnancy, and at any time. Research for children under 14 years old is carried out according to the doctor's prescription only in case of a strong need.

The main indication for the appointment of an X-ray to children is hip dysplasia, whether congenital or acquired. It should be known that in newborns up to three months of age the hip joints forming part of the bones consist mainly of cartilaginous tissue, which is poorly visualized on X-rays. Therefore, the procedure for children with suspected dysplasia is advisable to appoint only after reaching three months, and then after a preliminary ultrasound.

Methods of conducting the

study X-ray of the hip joints are performed in two projections - a straight and a side.

When performing direct shots a person lies on his back, his legs are straightened and turned inward by feet. The necessary position in this case is fixed by the X-ray laboratory assistant using special rollers. If the mobility of the joint is disturbed, the pictures are performed in the position of the patient lying on the abdomen with an elevated opposite half of the pelvis fixed with special devices. If the joint is unbent, direct shots are performed in the patient's semi-sitting position.

When carrying an X-ray in the lateral projection, the person lies on the back, the leg being examined is bent at the knee. There are pathologies in which it is not recommended to change the position of the diseased limb - in such cases the healthy leg is bent and the subject remains straightened.

Interpretation of the result

After receiving the required number of radiographs, they are deciphered by a radiologist. At the same time all joint elements are evaluated, the width of the joint gap is measured. When detecting tumors, their size and localization are determined.

On the x-ray images of the hip joint with the initial stages of arthrosis, the structure of the bone, the sharpening of the edge of the head of the thigh, is clearly seen. With advanced arthrosis, osteophytes( bone growths), single or multiple cysts, flattening and reduction of the femoral head are visible in the photographs.

The obtained images together with the conclusion of the radiologist are transferred to the attending physician for an accurate diagnosis. Literature

1. Reutsky IA, Marinin VF, Glotov A.V."Radial and instrumental diagnostics of the pathology of the hip joint and pelvis" 2. Filatov S.V."Early detection and treatment of the most common hip diseases in children and adolescents"

medoblako.ru

Hip dysplasia in children: photo, treatment, consequences of

What is it - congenital malformations caused by pathologies of the musculoskeletal system, which are elementship joint, in medicine is called - hip dysplasia( DTS). Disease, in one way or another, all its elements can be exposed:
  • acetabulum;
  • the head of the thigh and capsule;
  • underdevelopment of surrounding muscles and ligaments.

Brief description of the

The role of the hip joints is very great, they experience the main loads when a person walks, runs or just sits. Perform a huge number of different movements. The joint is a globular head located in a deep crescent-shaped acetabulum. The neck is connected with the other parts. Normal, complex operation of the hip joint is ensured by the configuration and the correct internal structure of all its components. Any disruption in the development of at least one of the component parts of the pronounced:
  • pathology and changes in the shape of the femoral head, mismatch of its dimensions with the size of the cavity;
  • by stretching the joint capsule;
  • is not the normative depth and structure of the hollow itself, its acquisition of an ellipsoidal, flat form, a thickening of the bottom or sloping "roof";
  • pathology of the cartilaginous margin - limbus;
  • by shortening the neck of the femur with a change in its antiversion and diaphyseal angle;
  • ossification of articular cartilage elements;
  • pathologies of the ligamentous apparatus of the head, manifested hypertrophy or aplasia
. This leads to disruption of the functional development of the entire hip apparatus, which is a DTS disease. Depending on the nature of the pathology, dysplasia of the hip joints is divided into different types.

Classification of DTS

Three main types characterize the pathology of DTS.1) To acetabular dysplasia, a disorder in the structure and pathology in the acetabulum itself, mainly pathology in the limbus cartilage, along the edges of the cavity, is attributed. Under the influence of the pressure of the head, it is deformed, forced outward or wrapped inside the joint. What facilitates the stretching of the capsule, the development of ossification of the articular cartilage and an increase in the displacement of the femoral head. 2) Mayer's dysplasia or epiphyseal is characterized by a pointlike ossification of the cartilaginous tissues that causes joint stiffness, pain and deformity of the legs. The defeat of the proximal femur, expressed by pathological changes in the position of the femoral neck of two types - dysplasia due to an increase in the angle of incidence, or dysplasia with a decrease in the diaphysial angle.3) Rotational dysplasia is characterized by delayed articular development and pathologies, manifested by obvious violations in the relative position of bones relative to the horizontal plane. In itself, such a situation is not considered dysplasia, most likely, it is a borderline condition. The degree of development of the disease depends on the severity of the pathological process.
  1. 1st, mild degree of DTS is called pre-forcing - it is characterized by small deviations caused by oblique acetabular angles of the acetabular roof. The position of the femoral head located in the joint cavity is slightly shifted.
  2. 2nd degree - subluxation - in the articular cavity is only part of the head of the femoral joint. In relation to the cavity, it moves outward and upward.
  3. 3rd - degree - dislocation, characterized by a complete exit of the head from the cavity direction up.

Causes of hip dysplasia

The causes of articular pathology in the hip joints are caused by several theories: 1) Theories of heredity - presupposing inheritance at the gene level, 2) Hormonal - the increase in the level of progesterone in the late stages of pregnancy leads to functional and structuralchanges in the muscular-ligament structures of the fetus, marked by instability in the development of the hip apparatus. 3) According to the multifactorialThere are several factors influencing the development of TPA: •
  • • gluteal position of the fetus;
  • deficiency of vitamin and microelements;
  • limited movement of the baby in the womb of the womb - usually, the mobility of the left leg of the baby is limited by pressing it against the wall of the uterus, so the left hip joint is more likely to become dysplastic.
As a result of long-term studies, a direct link has been established between the development of the disease and the swaddling of children. For example - in African and Asian countries, children are transferred on their backs, not swaddled, while retaining their relative freedom to their motor functions. Taking this as a basis, the Japanese broke their centuries-old foundations( dense swaddling under the DTS).The results were struck even by the most incredulous scientists - the growth of the disease was reduced by almost ten times against the usual.

Symptoms of hip dysplasia in children

A major role in identifying early symptoms of hip dysplasia belongs to parents if they pay due attention to the characteristic signs of dysplasia in children that are expressed:
  1. 1) Asymmetry of the location of wrinkles on the hips. There must be three in front and behind. When viewed, the legs should be unbent with the feet brought to each other. In pathology, on the affected side additional, deeper creases are added, both in the front and the gluteal side.
  2. 2) The restriction of leg recession is characteristic for the second and third degree of dysplasia. In the normal state of the baby's legs, in the bent state, it is possible to dilute completely to ninety degrees, with dysplasia not more than sixty.
  3. 3) The definition of Marx Ortolani is a symptom of the head slipping with a characteristic click when breeding and bringing the legs.
  4. 4) Shortening of the affected leg. You can determine by comparing the height of the knee joints.
Concomitant symptoms of dysplasia in children may be:
  • softening of the bones of the skull;
  • of the elongated shape of the foot or club foot;
  • neck curvature;
  • oppression of unconditioned reflexes( sucking and searching)

Diagnosis of hip dysplasia

The diagnosis of dysplasia of the hip joints is determined during examination by an orthopedic surgeon during a profile survey, often at the age of up to six months. The diagnosis is based on physical examination of the baby, certain tests and concomitant symptoms are used. In confirmation in polyclinic conditions, ultrasound is used, less often roentgenography.
  1. 1) SPL has the advantage among many other methods of research, since it is used from birth. It is the safest method( not invasive), available, and multiple use is allowed.
  2. 2) X-ray method is not inferior in reliability, but it has a number of features. First, children under one year of age are not recommended to have irradiation( unless the diagnosis of an ultrasound is in doubt or is not possible).Secondly, it is necessary to lay the child under the device with observance of symmetry, which in children is difficult.
  3. 3) Computer or magnetic resonance imaging is used when there is a question about surgical treatment. Gives a more complete, structured picture.
  4. 4) Arthrography and arthroscopy are used to complete the complete picture when diagnosing when conditions are triggered. The methods are invasive, performed under anesthesia, and are not widely used.
What to do with dysplasia of the hip joints in children: Dr. Komarovsky.

Treatment of hip dysplasia in newborns

In pediatric orthopedics, there are many methods of treating hip dysplasia in a child. Each doctor chooses an individual treatment program for his small patient, based on the severity of the disease. These are methods, from elementary broad swaddling to gipsovaniya malysha. I so. In order for some methods of treating dysplasia.
  1. 1) Wide swaddling is the most affordable way, even a young mother can perform, use in uncomplicated forms.
  2. 2) Becker's pants are the same as the wide swaddling, but are more convenient to use.
  3. 3) The tire or the pillow of the Freik is functional as well as panties, but it has stiffeners.
  4. 4) Pavlik's stirrups - came to us from the last century, but still in demand.
  5. 5) Splinting - use the Vilensk or Volkov bus( refer to the elastic type of splinting), also the grooming bus for walking, and gypsum splinting.
  6. 6) Surgical treatment - this method is used in severe forms, frequent relapses, in children older than one year of age.
Additional methods of treating dysplasia, they can also be the main ones when it comes to the immaturity of the joint elements, or about the prevention of DTS in children with a predisposition:
  • a general massage with an emphasis on TBS;
  • newborns gymnastics;
  • physiotherapy( using vitamin, with lidase, with calcium);
  • paraffinotherapy, applications on the TBS region;
  • dry heat, mud treatment.
The main principle of treatment is the timeliness and adequacy of the chosen method.

Than the consequences of dysplasia

are threatened. Children with dysplasia are not threatened with a recumbent lifestyle, but they begin to walk much later than their peers. Their gait is characterized by instability, lameness. Babies fall like ducks and slobbers. If you do not start early treatment of hip dysplasia, it threatens the development of spine pathologies in the form of lordosis, kyphosis or osteochondrosis. With age, non-eliminated hip arthritic pathologies lead to inability to withstand prolonged loads. The formation of new outlines of joints and cavities begins, the formation of a false joint, which can not be full, since it is unable to perform the function of support and full retraction of the leg. Develops - neoarthrosis The most serious complication is the formation of dysplastic coxarthrosis, in which the operation to replace the joint is inevitable. If treatment of early dysplasia takes up to a maximum of up to six months, treatment after twelve years can last for about twenty years.

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