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
