X-rays of the hip joint: norms in children and adults, preparing to perform
X-rays of the hip joint is by far the most common method of study of the human skeleton. Based on the result, the doctor can make a clear and right decision how to treat the patient who has problems with a hip joint, and this applies not only to adults but also to children.
X-ray bones of a basin is considered a simple and accessible method of research, but due to the fact that it has a harmful effect on the body and poor visualization of soft tissues on the images, are reluctant to practice in Pediatrics. It depends on the fact that infants up to three months of bones consist of cartilaginous tissue, and that's just hard to see in the pictures. Therefore, it is prescribed to children from the age of three, and is most often used for studying the hip joint by ultrasound.
X-ray of hip joints in infants is carried out for suspected congenital or acquired dysplasia of the hip joint. In medical practice there are three degrees of this problem:
During previlige, unlike dislocation, is such a moment, when the head loses partial contact with the acetabulum of the. In this case there is a displacement of the joint, and are only the symptoms of bone dysplasia. X-rays of the hip to children at such an early age are prescribed when diagnosed with slow development of joint or its deviation from the norm. This problem requires observation.
The earlier a doctor will prescribe this type of examination, the better will be able to help your child effective treatment.
Treatment will lead to the restoration of anatomical norms and good functional ability. The first and main signs of hip dysplasia in infants: limited abduction of the hip on the side of the affected area, asymmetry of folds on the hips. During dislocation occurs the shortening of the thigh, and if you try to take away, you hear a click. Another common indication for the operation of the x-rays in children are injuries of the hip joint, arthritis, osteoarthritis, suspected neoplasms, and other abnormalities.
Where and who assigns the research?
This problem do children's orthopedists, traumatologists, pediatricians and radiologists. X-ray children can be done in a public hospital or a private clinic, where there is a special machine for that. To prevent the development of pathology, it is necessary in the early stages of a child's life to undergo a thorough diagnosis that includes a complete inspection. But it is impossible to exclude and instrumental examination.
preparation for the procedure
do I Need a certain preparation for the procedure? Special preparation from the patient is not required. A specialist in the quality of training needs to prepare a special lead apron, which close the patient's body from unnecessary irradiation. Despite the fact that many specialists for x-rays, moms remain still against it. But ladies, you must understand that x-ray is considered an accurate method of diagnosing problems associated with the hip joint, and establishes the diagnosis with 70% accuracy.
Yes, x-rays are harmful, as there is a radiological burden on the child's body, and in the future there might be the development of hematologic abnormalities or changes with cancer. But on the other hand, if the specialist is competent, they will do the minimum dosage of radiation, and the procedure will take place with a minimum dose little harm to the patient. Those children under the age of three months, you need to abandon this procedure and to give preference to ultrasound.
Prior To the year of the child, you can conduct x-ray study, but only with the strict control of the dosage of radiation received. But it is better to give preference to ultrasound. And after, don't hesitate to do x-rays. In the first months of life the baby is difficult to diagnose hip dysplasia, as his muscles still atrophied. The only indicator of the presence of such a problem is considered to be a characteristic click.
Before doing an x-ray of a young child, you need to consider that they have bones instead of cartilage, and therefore fully to see the entire cavity of the joint is impossible. In this regard, there are certain schemes. After taking the shot, the doctor need to make the correct decision, for this purpose, a scheme of Hillenmeyer. It can help to analyze the performance of the joint, such as the acetabular angle, the distance from the line of Helenrazer to metaphyseal plates (h) and the bottom of the vestibular trough to h (d).
Ocabulary angle is two parallel lines which pass through the Upsilon-shaped cartilage. In normal condition the angle isa value of 30 degrees. This figure refers to children up to three months. After three months, it is reduced to 20 degrees. The value of h, if is wrong, can mean displacement of the hip joint, in the normal position it should be in the interval from 9 to 12 cm.
If it is less or more, the child has observed pathological process. If the gap from the bottom of the acetabulum to the value of h is 15 mm, it also shows there were problems. This scheme allows to study and to give a correct conclusion, it can be suspected the most minor changes and pathology. For a more precise assessment of using an additional line of Shenton and calve.
- first, it is impossible to carry out x-ray diagnosis, if disrupted immune system, since the probability that after this will help to appeal to hematologists, as there will be changes in the bone marrow.
- secondly, if there is a child's predisposition to cancer, namely radiation sickness.
- third, with extreme caution it is necessary to do x-rays for children, where there are pronounced defects of metabolism, while the weak supply of fabrics and with the apparent atrophy.
If possible, try to abandon the x-ray, because a little body is not really protected from x-rays. Do not spoil his health by this method of diagnosis. The last word, of course, will be for parents, but worth mentioning that it is not always the resulting harm is the cure of congenital dislocation.
In the end I wanted to note that this method of research is considered essential and indispensable for diagnosing dysplasia of the joints in children. But despite the fact that it is harmful, only x-rays can give a clear picture, through which you can determine the right direction in the treatment.