Diagnostic ultrasound ( PDFDrive )

1926 PART V Pediatric Sonography
A
B
C
D
E
FIG. 55.2 Coronal/Flexion Hip Views. (A) Linear array
transducer is coronal to lexed femur. (B) Normal hip
sonogram shows sonolucent femoral head (H) resting against
bony acetabulum (a). Note ibrocartilaginous tip of labrum
(arrow). (C)-(E) Dislocated hip sonograms. (C) Displacement
of sonolucent femoral head (H) laterally and superiorly with
deformity and increased echogenicity to labrum (curved arrow).
(D) Push maneuver shows displacement of femoral head
over posterior limb of triradiate cartilage (arrowhead). (E) Pull
maneuver reveals head no longer positioned over triradiate
cartilage (arrowhead) of posterior lip of acetabulum. H, Femoral
head; i, iliac line; L, lateral; S, superior line. See also Videos
55.1 and 55.2—normal; and Videos 55.3, 55.4, and 55.5—
subluxation and dislocation.
bone line: lat and straight) is a key to accurately visualizing the
midacetabulum and to obtaining the maximum depth of the
acetabulum. When the transducer is positioned too anteriorly,
the iliac line is inclined laterally; and if positioned too posteriorly,
the iliac line exhibits concavity. When the plane is not correctly
selected, it could be falsely concluded that the acetabulum is
maldeveloped. A normal hip gives the appearance of a “ball on
a spoon” in the midacetabulum. he femoral head represents
the ball, the acetabulum forms the bowl of the spoon, and the
iliac line is the handle. When the transducer is moved posteriorly
and the scan plane is over the posterior margin of the acetabulum,
the posterior limb of the triradiate cartilage, also known as the
“posterior lip,” becomes an easily recognized landmark. he bone
above and below the cartilage notch is lat, and the normally