| Internet Ultrasound Atlas of the Infant Hip |
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Hi I am looking for sonogram prints of interesant case ,exceptions etc. of the baby hip; specially where good mature hip Type I is worsening to decentering hip Type D/III/IV (with good quality of documentation ; I will pay to 100 eu for each) I have read about it in paper,but I have never seen ( I have examined personally about 200 000 infant's hip)
Type IIa+(GN coming to maturity) 6 weeks (below) the bony roof satisfactory modeling the bony rim angular but bony roof is only satisfactory ,the first part of bony roof is very good,but the second tail (deeper) is only satisfactory. the cartilage roof cover the head; the arrows show labrum (red) ; the bony rim (yellow); the lower iliac margin (blue) ,
the bony roof line (blue) is extends tangential to the lower iliac margin and tangent to the bony rim the cartilage roof line(green) is drown tangential to the bony rim and through the middle point of the labrum echo; asymmetry in the loose joint capsule; family DDH( when it occurs ask always about it) the baseline (yellow) is drown parallel to ilium echo through the point of the junction of the perichondrium,the periosseum and ilium.
type I (abow) 6 weeks the bony roof is good the bony rim blunt the cartilage roof cover the head; the arrows show labrum (red) ; the bony rim (yellow); the lower iliac margin (blue) ,
the bony roof line (blue) is extends tangential to the lower iliac margin and tangent to the bony rim the cartilage roof line(green) is drown tangential to the bony rim and through the middle point of the labrum echo ; asymmetry in the loose joint capsule ,family DDH( when it occurs ask always about it) the baseline (yellow) is drown parallel to ilium echo through the point of the junction of the perichondrium,the periosseum and ilium.
type IIa ( below ) 4 weeks the bony roof is adequate the bony rim rounded the cartilage roof cover the head; the arrows show labrum (red) ; the bony rim (yellow); the lower iliac margin (blue) ,
the bony roof line (green) is extends tangential to the lower iliac margin and tangent to the bony rim the cartilage roof(blue) is drown tangential to the bony rim and through the middle point of the labrum the baseline (yellow) is drown parallel to ilium echo through the point of the junction of the perichondrium,the periosseum and ilium.
type D(up) 4 weeks the bony roof severely deficient , the bony rim flattened the cartilage roof dispalced; the arrows show labrum (red) ; the bony rim (yellow); the lower iliac margin (blue) ,
the bony roof line (green) is extends tangential to the lower iliac margin and tangential to the bony rim the cartilage roof line(blue) is drown tangential to the bony rim and through the middle point of the labrum the baseline (yellow) is drown parallel to ilium echo through the point of the junction of the perichondrium,the periosseum and ilium.
type IIc (up) 6 weeks the bony roof severely deficient , the bony rim flattened the cartilage roof still covers ; the arrows show labrum (red) ; the bony rim (yellow); the lower iliac margin (blue) ,
the bone roof line (red) the cartilage roof line(pink) the baseline (yellow)
type D(up) 1 weeks the bony roof severely deficient , the bony rim flattened the cartilage roof dispalced; the arrows show labrum (red) ; the bony rim (yellow); the lower iliac margin (blue) ,
the bony roof line (green) the cartilage roof line(blue) the baseline (yellow)
type I (below) 6 weeks asymmetry in the loose joint capsule;family DDH ( when it occurs ask always about it) the bony roof is good the bony rim blunt the cartilage roof cover the head; the arrows show labrum (red) ; the bony rim (yellow); the lower iliac margin (blue) ,
the bony roof line (blue) is extends tangential to the lower iliac margin and tangent to the bony rim the cartilage roof line(green) is drown tangential to the bony rim and through the middle point of the labrum echo ; asymmetry in the loose joint capsule ,family DDH( when it occurs ask always about it) the baseline (yellow) is drown parallel to ilium echo through the point of the junction of the perichondrium,the periosseum and ilium.
type Type GN (coming to maturity) (Physiologically immature, border type between I and II) (up ) 6 weeks asymmetry in the loose joint capsule;family DDH ( when it occurs ask always about it) the bony roof is adequate the bony rim blunt the cartilage roof cover the head; the arrows show labrum (red) ; the bony rim (yellow); the lower iliac margin (blue) ,
the bony roof line (blue) is extends tangential to the lower iliac margin and tangent to the bony rim the cartilage roof line(green) is drown tangential to the bony rim and through the middle point of the labrum echo ; asymmetry in the loose joint capsule ,family DDH( when it occurs ask always about it) the baseline (yellow) is drown parallel to ilium echo through the point of the junction of the perichondrium,the periosseum and ilium.
type D(up) decentirc hip 3 days newborn with normal arterial supply at the cartilage femoral head in power doppler the arrows show the arterial main supplay from a.circumflexa medialis (red) ; Parallel projection to artery (yellow); Traverse projection to artery(green) arterial supplay from a.lig.teres (blue)
the bony roof severely deficient , the bony rim flattened the cartilage roof dispalced;
normal position obduction 60 degree
type IV (up) eccentric hip 4weeks the apex of the femoral head is upper to highest point of cartilaginous roof bony roof poor , superior bony rim flattened cartilage roof dispalced pressed downwards; arrows show labrum (red) ; bony rim (yellow); lower iliac margin (blue) , displaced joint capsule (green)
type IV (up) eccentric hip 6 days the apex of the femoral head is upper to highest point of cartilaginous roof bony roof poor , superior bony rim flattened cartilage roof dispalced pressed downwards; arrows show feamoral head (red) ; and displaced joint capsule
type IIIb 8 weeks . the bony roof poor , the bony rim flattened the cartilage roof dispalced; pressed upwards with structural alteration (echogenic) orange arrows the arrows show labrum (red) ; the bony rim (yellow); the lower iliac margin (blue) ,
Type IIa(GN) 6 weeks (up) the bony roof satisfactory modeling the bony rim angular but bony roof is only satisfactory ,the first part of bony roof is very good,but the second tail (deeper) is only satisfactory. the cartilage roof cover the head; the arrows show labrum (red) ; the bony rim (yellow); the lower iliac margin (blue) ,
the bony roof line (pink) is extends tangential to the lower iliac margin and tangent to the bony rim the baseline (magneta) is drown parallel to ilium echo through the point of the junction of the perichondrium,the periosseum and ilium.
type III a (up)1 week . the bony roof poor , the bony rim flattened the cartilage roof dispalced; pressed upwards without structural alteration(devoid of echo) the arrows show labrum (red) ; the bony rim (yellow); the lower iliac margin (blue) ,
Type II / IV 6 weeks
the bony roof is deficient(adequate to type II) but
the cartilage roof dispalced pressed downwards(adeguate to type IV);
Type I abdominal silhouette of the os ilium Type IIB (4.5 months.old) the femoral head is pressed to external border of the acetabullum with contracture of the muscles (ultrasound head turn to the right)
( ultrasound head turn to the right) abdominal ( ultaosound head turn to the left) dorsall
Pavlik harness treatment 2 weeks Type IIa- 4 weeks (below) before treatment Type IIc 6 weeks after trreatment The bony rim flattened (red arrow ) becouse in this age os is lighter then muscls and ligaments
Type GN (above) second left hip slighty worsennig to type IIa too
type I red points shows labrum left ; the bony rim medium; the lower iliac margin right
Type IIc red points shows labrum left ; the bony rim medium;( two points) the lower iliac margin right
Typical mistake ( Ortholani sign after born ortopaedic control for 3 weeks .) during ortopaedic control 3 weeks old baby Type IIa @ 56 B 53 ( typical error) automatical measuring the alpha i beta angles ; Type D @46 B 87( correct angles valuae) Type IV next control after 8weeks
the same problem with second hip Type I @ 62 B 47 ( typical error) automatical measuring the alpha i beta angles Type IIa @57 B 76( correct angles valuae)
type IIIa below 8 weeks sonograms of the same hip but difrent us devices
type III a (up)1 week . the bony roof poor , the bony rim flattened the cartilage roof dispalced; pressed upwards without structural alteration(devoid of echo) the arrows show labrum (red) ; the bony rim (yellow); the lower iliac margin (blue) ,
Type I 4 weeks
Type I Type II/D 10 weeks
family DDH Type II a 7 weeks ( below) asymmetry in the loose joint capsule;( when it occurs ask always about family incidence)
Type IIa 7 weeks old muscles contracture and displaced of femoral head to the outer end of acetabulum with pseudo Barlow sign
type IIIa i Type IV 7 days old with right instability
górny prawy Typ IIa lewy dolny Typ IIa wyglada trochę lepiej ale panewka jest płytsza niz prawego głowa przesunieta obustronnie stawy na granicy leczenia dolna norma dla II
dzieci siostry(DDH) i brata( po prawej) w prawie tym samym urodziły sie widac wybrzuszenie torebek na zewnatrz dolna granica typu II, biodra siostry dziecka troche gorszy wyglad ale troche w nastepnej kontroli sie poprawiły
Type II/D (up and below) Type IIIa (up) shallow acetabullum , femoral head dispalced
type D(up) the bony roof severely deficient , the bony rim flattened the cartilage roof dispalced;
type D(below) 5 weeks angle @ 48st angle B 85; the bony roof severely deficient , the bony rim flattened the cartilage roof dispalced; the arrows show labrum (red) ; the bony rim (yellow); the lower iliac margin (blue) ,
the bony roof line (green) the cartilage roof line(blue) the baseline (yellow)
type II/D up typical error of measurement as type I ( ange @ 62st ange B 55) be careful during diagnosis ,when view and desciption of the hip are difrent to the alpha angle value .
typevD kąt @ 48st kat B100; type D(up) 1 weeks the bony roof severely deficient , the bony rim flattened the cartilage roof dispalced; the arrows show labrum (red) ; the bony rim (yellow); the lower iliac margin (blue) ,
the bony roof line (green) the cartilage roof line(blue) the baseline (yellow)
type IV (up) eccentric hip 4 weeks the apex of the femoral head is upper to highest point of cartilaginous roof bony roof poor , superior bony rim flattened cartilage roof dispalced pressed downwards; arrows show femoral head (red) ; and displaced joint capsule
type IIIb 6months old baby left hip 2 sonograms and rtg picture you can see echo of secondary acetabulum . the bony roof poor , the bony rim flattened the cartilage roof dispalced; pressed upwards with structural alteration
Michał Kulej
Ultrasound Atlas of the Infant HIP
type IIa 6 weeks the bony roof satisfactory modeling the bony rim angular but bony roof is only satisfactory ,first part of bony roof is very good,but second tail (deeper) is only satisfactory. the cartilage roof cover the head; the arrows show labrum (red) ; the bony rim (yellow); the lower iliac margin (blue) ,
the bony roof line (blue) is extends tangential to the lower iliac margin and tangent to the bony rim the cartilage roof line(green) is drown tangential to the bony rim and through the middle point of the labrum echo; asymmetry in the loose joint capsule; family DDH( when it occurs ask always about it) the baseline (yellow) is drown parallel to ilium echo through the point of the junction of the perichondrium,the periosseum and ilium.
type I (abow) 6 weeks the bony roof is good the bony rim blunt the cartilage roof cover the head; the arrows show labrum (red) ; the bony rim (yellow); the lower iliac margin (blue) ,
the bony roof line (blue) is extends tangential to the lower iliac margin and tangent to the bony rim the cartilage roof line(green) is drown tangential to the bony rim and through the middle point of the labrum echo ; asymmetry in the loose joint capsule ,family DDH( when it occurs ask always about it) the baseline (yellow) is drown parallel to ilium echo through the point of the junction of the perichondrium,the periosseum and ilium.
typIIa ( below ) 4 weeks the bony roof is adequate the bony rim rounded the bony roof cover the head; the arrows show labrum (red) ; the bony rim (yellow); the lower iliac margin (blue) ,
the bony roof line (green) is extends tangential to the lower iliac margin and tangent to the bony rim the cartilage roof(blue) is drown tangential to the bony rim and through the middle point of the labrum the baseline (yellow) is drown parallel to ilium echo through the point of the junction of the perichondrium,the periosseum and ilium.
type D(up) 4 weeks the bony roof severely deficient , the bony rim flattened the cartilage roof dispalced; the arrows show labrum (red) ; the bony rim (yellow); the lower iliac margin (blue) ,
the bony roof line (green) is extends tangential to the lower iliac margin and tangential to the bony rim the cartilage roof line(blue) is drown tangential to the bony rim and through the middle point of the labrum the baseline (yellow) is drown parallel to ilium echo through the point of the junction of the perichondrium,the periosseum and ilium.
under construction
: w przypadku wysuwania głowy z panewki nie zawsze jest to już pozycja standardowa; sylwetka kosći biodrowej pochyla sie i powiniśmy kreślic linie zgodnie z odchyleniem w lewo druga żółta liinia kropkowana ( trzeba o tym pamiętac bo z D wykreślimy I prawidłowy kąt @ o wartości 62 st jest to najczęstszy błąd; u kikutygodniowych niemowląt kiedy zmiany wtórne nie sa jeszcze wykształcone; o poważnych konsekwencjach zwłaszcza jeśli korzystamy z programów do automatycznego wykreslania kątów )
type IIc (up) 6 weeks the bony roof severely deficient , the bony rim flattened the cartilage roof still covers ; the arrows show labrum (red) ; the bony rim (yellow); the lower iliac margin (blue) ,
the bone roof line (red) the cartilage roof line(pink) the baseline (yellow)
type D(up) 1 weeks the bony roof severely deficient , the bony rim flattened the cartilage roof dispalced; the arrows show labrum (red) ; the bony rim (yellow); the lower iliac margin (blue) ,
the bony roof line (green) the cartilage roof line(blue) the baseline (yellow)
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rtg secondary acetabulum