Arthrography is a useful resource, especially for pediatric orthopedic surgery. Periarticular structures in pediatric patients can be difficult to identify and assess secondary to the cartilaginous nature. Improved visualization of a given structure is integral to patient care, as this may impact surgical management for a given condition. Arthrography is useful for the evaluation of the pediatric hip joint, specifically as it pertains to developmental dysplasia of the hip.
Originally, arthrography was primarily used as an adjunct to radiography for diagnostic joint evaluation. More recently, CT and MRI have replaced arthrography for diagnostic purposes. Arthrography remains a helpful resource in the operating room. While the patient is under general anesthesia, arthrography provides diagnostic information that directly impacts decision-making.
The hip radiograph in a pediatric patient cannot yield all the information desired to diagnose or treat developmental dysplasia of the hip. Pediatric hip structures that are cartilaginous are not easily identified on plain radiographs. Hip arthrography can be used to visualize these cartilaginous structures. Hip arthrography aids the pediatric orthopedic surgeon in establishing a diagnosis and treatment for developmental hip dysplasia.
Hip arthrography is safe, minimally invasive, quick, and inexpensive when performed correctly. Arthrography is paramount for evaluating and managing pathology in the pediatric hip because it allows for visualization of the femoral head, acetabulum, and any soft tissue blocks to adequate hip reduction.
Evaluation of the pediatric hip with arthrography demonstrates the cartilaginous anatomy of the acetabulum and femoral head. Arthrography is a dynamic test to assess the stability and quality of hip reduction. Hip arthrography plays an integral role in the decision between closed and open reduction in patients with developmental dysplasia of the hip.
Weishuhn LJ, Seidman A. Hip arthrogram. 2023 Mar 1. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan–. PMID: 36256782.