Chapter 23

which of the following statements regarding evaluation of the hips is FALSE?

a dislocated hip will sit completely out of the acetabulum

torticollis

a head that is held sideways due to a muscle contraction

The rounded femoral head sits in the _______.

acetabulum

in the coronal scan plane, the femoral head is seen sitting in the _______. The _____ ______ should appear as a straight line.

acetabulum, iliac line

when drawing the lines on a n infant hip joint, what is the location of the first line?

aligned with the ilium and extens through the femoral head

when does DDH occur most commonly

at birth

An _______ ______ is considered a strong positive Barlow and Ortolani sign.

audible clunk

Which are risk factors for developing DDH?

babies born in the breech position, positive family history, high birth weight

in which of the following maneuvers does the examiner attempt to push the femoral head out of the socket?

barlow maneuver

what is defined by the alpha angle?

bony or osseus roof of the acetabulum

The femoral head is composed of _______ at birth. It begins to ossify from the center outward between _______ months.

cartilage, 2-8

what is defined by the beta angle?

cartilaginous roof of the acetabulum

what are the two most common methods used to evaluate for DDH

clinical assessment and sonography

When evaluating for a hip effusion, the normal hip capsule has a _______ appearance, whereas if an effusion is present the capsule bulges ____. An abnormal appearance is defined as a capsular thickness greater than 2-5 mm.

concave, outward, 2-5

which scanning plane allws for an assesment of the femoral head coverage with respect to how well it is contained in the acetabulum?

coronal

what term defines a complete displacement of the head out of the acetabulum?

dislocation

to obtain the alpha and beta angles when drawing the lines on an infant hip joint, where is the location of the third line?

extends from the bony edge of the acetabulum at the triradiate cartilage to the lowest point of the ilium

when drawing the lines on an infant hip joint, where is the location of the second line?

extends from the ilium along the labrum

An increased incidence of developmental dysplasia of the hip is associated with which of the following factors?

female

In a coronal/flexion image of the hip, the hip has a ball on a spoon apearance. The ball is the _______ ______, the ______ ______ represents the handle of the spoon, and the scoop of the spoon is the ______.

femoral head, iliac line, acetabulum

In the transverse scan plane, the _____ ______ and the _____ form a U or V configuration around the ______ _____.

femoral shaft, ischium, femoral head

using infant hip line drawings on a coronal scanning plane, where is the formation of the alpha angle?

formed between the 1st and 2nd line

using infant hip line drawings where is the formation of the beta angle?

formed between the first and third lines

When a child presents with hip pain, fever, limited movement, and refusal to bear weight, sonography can be used to evaluate for the presence of a _____ ______.

hip effusion

The hip bone is composed of the _____,______ and ______.

ilium, ischium, pubis

osteomyelitis

infection of the bone marrow and bone

developmental dysplasia of the hip describes a rand of dysplasia including: ______, ______ and frank _______.

instability, subluxation, dislocation

erythrocyte sedimentation rate

laboratory test that is a nonspecific indicator for inflammation

when scanning the infant hip joint, why is a linear transducer preferred over a sector transducer?

larger footprint

During fetal development, _____ ______ contribute to the laxity of fetal ligaments.

maternal hormones

The bones, connective tissues and muscles derive from which germ layer?

mesoderm

which germ cell layer are the bones, connective tissues, and muscles derived from?

mesoderm

adduct

move toward midline

what is the impression of the hip if the alpha angle is greater or equal to 60 degrees?

normal

what is the impression of the hip if the beta angle is less that 55 degrees?

normal

which treatment braces the hip in abduction and flexion so the acetabulum will remodel as the femoral head is placed to rest centered in the acetabular socket?

placing infant in a pavlik harness

which of the following is NOT a risk for developing DDH

polyhydramnios

what self limiting disease that is often treated with anti inflammatory medication is a relativel common cause of painful hip in children?

transient synovitis

_____ _____ can be treated with anti inflammatory medication and rest, whereas _____ _______ is a more serious bacterial infection that is typically trated with intravenous antibiotics.

transient synovitis, septic arthritis

which cartilage is a useful landmark that connects the ilium, ischium and pubis?

triradiate cartilage

how is barlow maneuver used to asses hip stability?

used as as attempt to push the femoral head posterioly out of the socket

how is the ortolani maneuver used to asses hip stability?

used to reduce a dislocated hip

The frequency of DDH is _____ in _____

10, 1000

how many infant hip joint sonography examinations are recommended for the sonographer to gain adequate experience to reproduce accurate evaluations of the infant hip joint?

100

after approximately what age does sonography evaluation of the infant hip become less reliable than radiography?

6 months

An alpha angle of greater than or equal to _____ _____ is considered normal.

60 degrees

oligohydramnios

a decreased amount of amniotic fluid around the fetus

what can happen to the subluxed or dislocated hip when it is rotated outward or abducted?

reduce the subluxation or dislocation

what bacterial infection is considered a medical emergency requiring rapid treatment to avoid long term sequelae that includes avascular necrosis to the femoral head?

septic arthritis

Imaging is performed with and without ______. Imaging planes include the _______ plane without _____ and the __________ plane with and without _______.

stress, coronal, stress, transverse, stress

which condition is described if a hip demonstrates posterior, superior, and lateral displacement of the femoral head during flexion?

sublexed

what term describes an incomplete displacement of the femoral head from the acetabulum?

subluxation

which of the following statements regarding the transverse scan plane is FALSE?

the alpha and beta angles are taken in this plane

which of the following statements regarding the alpha angle is FALSE?

the alpha angle is obtained in the transverse plane

mesoderm

the middle germ cell layer that contributes to the embryologic development of connective tissue, bone, blood muscle, vessels, and lymphatics

abduct

to move away from the midline

arthrocentesis

to remove fluid from a joint through a needle

A 3 year old patient presents with a low grade fever and refusal to bear weight on her left hip. She recently had an upper respiratory infection. What is the MOST likely diagnosis?

transient synovitis