VOL.
No.
124,
ARTHROGRAPHY By
IN S. TANAKA,
OSTEOARTHRITIS
M.D.,
T.
ITO,
M.D.,
KYOTO,
S INCE
arthrography
Shievers
tion
in
ofthe
on
this
hip,
was first for congenital reports have
1937
many
subject.’8”#{176}”4
To
date,
American Journal of Roentgenology 1975.124:91-95.
K. YAMAMOTO,
and
needle
method
tip
tion
of
more
intense
in
intense
pain
garding
duration variation,
dislocation.
To
of
the
hip
accounts change,
in
which
for more arthrography
in Japan.
measure
However,
since
the
management
hip,
and
ceived
of
certain
in
the
terial. indeed carried is
is used
To ensure enter the out under
inserted
as
dren. femoral
from
the
anterior
re-
tip
of
the
ma-
needle
side
of
the
advanced straight, is felt immediately Even if it feels that has
come
in
total is
cannot
amount injected,
* From
be
advanced
any
of 3-5
ml. of contrast
after
determining
the Department
of Orthopaedic
further,
Surgery,
The
injection
is
to individual within mm-
hours
at
the
B,
the
shows
is almost findings
identical in
arthro-
of the
infants
orbicular
hip
with
the
and
of acetabular labrum, lateral
medium,
latest.
FINDING5
medium
around
contrast
chil-
roof puddle zone,
and of
ring
medium
medial
and
as a whole. Median
pooling.
as in the arthrosis,
initial and advanced stages as graded by the Japanese
thopaedic
Association,
tion
of
and
however, femoral always
the
as well
due
of Or-
pooling
can
terminal
stage
despite lateral head, a marked
found
osteophyte
to the
deviaretenpresence
the form of capital drop from acetabular bottom pooling usually tends to
in
double floor Median
decrease increase
In
the
pooling
prearthrosis
median
noted.
is not
margin.
In
median
to
ligament
distinctly
forms
lateral
transverse
of an
by by
abduction adduction
of the (Fig.
hip
joint
a the of Medicine,
91
Kyoto
to
University,
Kyoto,
Japan.
2,
1
and
and
B). the degree of centripetal position of the head to the acetabular socket, the state of pooling changes. When the opaque medium of median pooling shifts
According
medium
Faculty
and
of arthrosis, tion of the
contact
that
2
contrast
be
with bone in the joint cavity, it has frequently been found that the tip has not yet reached the joint cavity, due to the capsular thickening. Despite a strong resistance which may at first be encountered, the needle should be advanced further until a second strong resistance is felt. When the needle
joint.
of the
the femoral neck, and puddle of contrast medium medial and lateral to the transverse ligament are observed in arthrograms of the hip. Puddle of
that the injection does joint, the procedure is fluoroscopy. The needle
greater trochanter and until strong resistance below the femoral head. the
contrast
causes
intracapsular
is subject occurs to
and
Cartilages head,
contrast
of
of
in osteoarthritis
arthrographic
Kyoto arthrogout for factors
the
result
pain relief
/1
I,
Injec-
passing with the absorpmedium; however, the
findings
of an adult
De-
osteoarthritis
significant
osteoarthritic
earliest,
Figure
METHOD
76
the
graphic
attention.
Urografin
at
a rise
ARTHROGRAPHIC
dysplasia
partment of Orthopaedic Surgery, University Hospital, preoperative raphy has usually been carried operative
utes
cent of the been used
1968,
the
as the
capsule.
frequently
to
of the and
osteoarthritis
8o per has rarely
ml.
due
usually transient, tion of the contrast
angle in aceis the pro-
acetabular
than
in the
than
pain
pressure
irreducible
HIP*
M.D.
is indeed
has become an indispensable test in the treatment of congenital dislocation of the hip in infants and children, especially rethe cartilaginous acetabular tabular dysplasia, arthrography cedure of choice. In general, when treating
THE
JAPAN
done by dislocaappeared
this
OF
S. Tanaka,
92
T. Ito
and
K.
Yamamoto
MAY,
1975
C
American Journal of Roentgenology 1975.124:91-95.
E
0 FIG.
(A
i.
B)
and
acetabular
Schematic
roof;
E=orbicular
drawing
B=cartilage
zone;
and
an
of femoral
F=ring
of contrast
arthrogram
head;
of
initial
C=labrum;
medium
around
stage
of
the
femoral
pooling
neck;
A
osteoarthritis.
D=lateral
cartilage
=
of contrast
of
medium;
G=puddle of contrast medium I = puddle of contrast medium on J = subcapital puddle of contrast
on the medial side of the transverse ligament; H = transverse ligament; the lateral side of the transverse ligament; G and I form median pooling; medium.
laterally the fit
due of
to abduction
the
abduction,
in
dian
pooling
many
an
indication
Arthrography
should
onstrate is
the
state
difficult
roentgen
arthrographic strated
roentgenograms.
this
joint
In
on
prearthrosis articular
to dem-
when type
of
functional
and cartilage
as is evident from This is well demon-
findings. in
space
the
in
at at
ready
the
stage
this the
of
degenerates
Even bearing
disappeared,
joint
or the
known
better
the
cartilage potential
at
of adduction
hip
functional
and
irregularity
of
joint has al-
wear
adjacent
of
portion area
in
its
usually
the
of
bearing
b
3). In case joint,
the
for required.
accomplished
impossible
when portion
surgery,
indications surgery
is
degree
weight
before the of
and
Osteotomy
stage. weight
only on the weight on the adjacent
conventional
advanced
done space
termine the type
the
maintained,
decreases.
out
pooling,
the
cartilage
thickness
be
determine based
pro-
arthrosis,
osteotomy.
of median
7oint cartilage. In initial stage of arthrosis, is sufficiently
fre-
thus
valgus
by congruity studies alone.
osteotomy
congruity
adduction, be carried
to
to
hand, mecases due to
some
for
joint, due
indicating
other
time,
by
improves
viding
the in
this
At
hip
improves
instances
On decreases
adduction. quently
of the
also
osteotomy.
varus
it
joint
should
order
this
to
repair
This
de-
and can be
arthrography
(Fig.
contracture
of the
roentgenography
arthrography the
articular
bearing
part.
of the
adjacent
part
of the
cartilage
will
is
reveals cartilage
portion,
When
the
is intact,
usually
the not
but
also
cartilage
regeneration
take
place
after
American Journal of Roentgenology 1975.124:91-95.
VOL.
No.
124,
Arthrography
I
in Osteoarthritis
pooling
osteotomy. ing
In cases
of the
area,
joint
resulting
with
of the
weight
bearing
in
exposure
of
subchon-
an
bone,
regeneration
not
usually
occur, is the for
narrow-
space
dral
arthrodesis Indication
extensive
increases
of
and
cartilage
surgery osteotomy
by adduction,
decide reduction
does
arthroplasty
or
and
whether is
labrum
in
consists
of
initial
the
original
when the congruity of the joint is improved by abduction or adduction of the hip joint as viewed on conventional roentgenograms; (2) when arthrograph reveals change of median pooling by abduction or adduction of the hip joint, and also shows intact cartilage of the new weight bearing portion after osteotomy.
the
acetabular
roentgen
findings
ilcetabular ular
labrum
that
observed
While pediatrics tilaginous
this
is
as
labrum.
in in
Presence
infants
the acetabular
(i)
of an
arthrography
procedure for
follows:
is
and is
of
small
similar
in of
and
to
children.
significance
measurement
angle
acetab-
in order
car-
to
93
decreases
by abduction.
a factor disturbing the significance
osteoarthritis the
of
length
(Fig.
is carried
out
stage
of
basis
Hip
or not present,
tabuloplasty or
of choice. on the
of the
of
the 4). for
labrum
\Vhen
the
roof
of
simply ace-
prearthrosis
arthrosis,
acetabular
hip
to
length
the
of
end
is important.
of
When
a new acetabular roof is prepared beyond the length of the acetabular labrum, pressure against the new acetabulum is different either in the presence and absence of acetabular
labrum,
occasionally the edge. rum
and
cystic
change
or
fracture-like changes occur at Resection of the acetabular lab-
would
result
buffer
mechanism
pared
acetabular
femoral
head
in
disappearance
at
this
site
of and
the
the pre-
roof may compress the to accelerate changes of degenerative arthritis of the hip. Resection of the acetabular labrum should therefore be avoided.
S. Tanaka,
94
T.
Ito
and
K. Yamamoto
it.
The
MAY,
reasons
were:
when utilizing osteoarthritis,
arthrography tion of the an
hip
operative
with
can
accuracy
and
findings,
as applied compared
often
based
functional
be
on
roentgen
difficult to decide ure based on these
carried for
as
prearthrosis
arthrosis,
American Journal of Roentgenology 1975.124:91-95.
an
When
out.
and
vanced
stages
findings
are
on
auxiliary
of
procedand then
procedure
acetabuloplasty and the initial for
arthrosis,
indeed
of where and
conventional
of the it is
when
operative alone,
osteotomy
terminal stage, loss of joint space served
on the findings
made
convenstudies.
In many patients with osteoarthritis hip, however, there are instances
arthrography
to to
used for congenital dislocain pediatrics; (2) decision for procedure
relative
tional
definite
(i)
arthrography are lacking,
1975
is
is done stage of
initial
or
ad-
In
the
arthrographic
great
value.
there is extensive joint cartilage as obroen
tgenograms,
DISCUSSION
To
evaluate
arthritis
the
of the
hip
symptoms and
make
of
osteo-
a decision
as
the adequate operative procedure required, the clinical picture such as pain, ability to walk, joint mobility, activities of daily living as well as the roentgenograms should be studied.9”3 It is sometimes difficult to evaluate the disease based on clinical and roentgen studies alone, and at this time the operative procedure itself has to to
be
carefully
cumstances, clearance should carried surgery.
considered procedure
preoperative
considered.
Under
such
cir-
an auxiliary method such as of radioisotopes from the joint be used.’2 As a rule, arthrography is out
in
In
the
to in
patients past,
be
hospitalized arthrography
a necessary
osteoarthritis
investigation
for was
not
preoperative the hip, and did not include of
FIG. 4. Acetabular
labrum with acetabular dysplasia. The new acetabular roof should be made so as to cover the acetabular labrum.
VoL.
No.
124,
Arthrography
i
arthrography tients
is not
over
terminal
50
years
stage
years
of
age
with
plus
intense
of
range
of
or
pain,
preclude
any
greatest
In
of
ar-
stage
marked
motion
o
and
decrease giant
cystic
head or acetabureplacement is is eliminated to
additional
risk
complication
of infection-
of
total
hip
re-
2.
4.
6.
done on patients to remedy osteo-
of the
hip
in os-
are
not
so significant
8.
vary
dislocation of the hip of and children, nevertheless this is a method since arthrographic findings at each stage and can be compared
with
the
infants useful
congenital
clinical
picture
and
patients
tabuloplasty, nificance and
requiring
osteotomy
or
K.
NAKAMURA,
SEVERIN,
E.
location
of
9.
this method is of great sighas proved entirely adequate.
Tanaka,
II.
evaluation Orthop.,
J.
Ohara English 14.
mit
der
Arthrographie
V.
Unsere der
Erfahrungen Behandlung
der
K.
128
Bone
& Joint
RAD.
hip:
analyses.
1973,
correlation
Cent.
15,
345-354.
of
M. Studies congenitally Studies
normal
hip
J.
Orthop.
&
THERAPY
zi8, 870-875. ITO, T., SHINAGAWA, Y. Computer analysis
ponent
Surg.,
K., and ToRIof technetium pertechwith arthrosis deformans.
joint
arthritic
hip.
1-1286.
ROENTGENOL.,
S.,
I.
of
45, 813-833. reduction in congenital
HAMAMOTO,
Clearance
MED.,
Y05HIzUMI,
osteoarthritis
and ITO, ‘F. Clinical for osteoarthritis of hip. Clin.
20,
from
TANAKA,
Jap.
1971,
of hip. J. 363-371. M0RI, E.,
1969,
J.
ture Part
REFERENCES I. HEIMGARTNER-HAUSER,
dis1939,
after
S., ITO, T.,
TANAKA,
1972,
manuscript.
in congenital & Joint Surg.,
for
scale
NUCLEAR
Miss
of conOrthop.
Jap.
dislocation
joint
E. W. Open
netate
of the
Kon-
Unfall-Chir.,
study
Arthrography J. Bone
treatment
dislocation 1953,35-B, TANAKA, S.,
AM.
The authors wish to thank help in the preparation
u.
J.
hip.
SHINAGAWA,
for
orthop.
Orthop. A.,
SOMERVILLE,
13.
der
angeborenen
Arthrographic
of
10.
M.D.
26 Shimogamo-Higashitakagi-Cho Sakyo-ku, Kyoto 6o6 Japan
Grenzen
of hip: declosed reduction. J. Bone & Joint Surg., i 950, 32-A, 507-5 i 8. SHIMA, Y., TAMAKI, T., YOKOZAKI, M., ‘IANAKA, S., YOSHINAGA, H., TAGAWA, H., and UENO, R. Comparative studies of various
ZUKA,
Seisuki
und
E. Congenital
J. Jap.
12.
of “true”
304-313.
SEvERIN,
operative
ace-
reduction
bei der sogenannten
velopment
conventional
roentgen findings. Thus arthrography is useful to assess the total disease picture and to decide on the operative procedure required. In
of open
congenital luxation of hip. 7. Bone & Joint Surg., 1948,30-A, 875-882. MITCHELL, G. P. Arthrography in congenital displacement of hip. 7. Bone & Joint Surg.,
2!,
in
975-983. J. Results
genital dislocation ofhipjoint. A., 1968, p, 491-511.
7.
findings
H#{252}ftgelenkes.
276-287.
D. Development of acetabular hip: arthrographic and histo7. Bone & Joint Surg., 1965,
H#{252}ftluxation. Arch. 1965,58, 115-144.
Arthrography is usually hospitalized for surgery arthritis of the hip. While the arthrographic
des 107,
1970,
1963, 45-B, 88-95. 5. MOTTA, C. Moglichkeiten
CONCLUSION
American Journal of Roentgenology 1975.124:91-95.
R. roof in fetal logical study.
trastfullung
teoarthritis
95
Dysplasie
LAURENSON,
47-A, 3. LEvEUF,
placement.
as
Hip
Ztschr. Orthop.,
of
over
of the kongenitalen
pa-
a picture those
advanced
in
lum, total indicated.
done. with
age
the femoral hip prosthetic Arthrography
formation
the
of
arthrosis,
throsis the
always
in Osteoarthritis
on
joints
principal
J. Orthop.
com-
Traum.,
in cartilagenous dislocated hip cartilagenous
by
A.,
and
Jap.
Y., and of osteo-
means
‘957,3!,
structure of
arthrography.
736-750.
strucjoints. of
No.
124,
ARTHROGRAPHY By
IN S. TANAKA,
OSTEOARTHRITIS
M.D.,
T.
ITO,
M.D.,
KYOTO,
S INCE
arthrography
Shievers
tion
in
ofthe
on
this
hip,
was first for congenital reports have
1937
many
subject.’8”#{176}”4
To
date,
American Journal of Roentgenology 1975.124:91-95.
K. YAMAMOTO,
and
needle
method
tip
tion
of
more
intense
in
intense
pain
garding
duration variation,
dislocation.
To
of
the
hip
accounts change,
in
which
for more arthrography
in Japan.
measure
However,
since
the
management
hip,
and
ceived
of
certain
in
the
terial. indeed carried is
is used
To ensure enter the out under
inserted
as
dren. femoral
from
the
anterior
re-
tip
of
the
ma-
needle
side
of
the
advanced straight, is felt immediately Even if it feels that has
come
in
total is
cannot
amount injected,
* From
be
advanced
any
of 3-5
ml. of contrast
after
determining
the Department
of Orthopaedic
further,
Surgery,
The
injection
is
to individual within mm-
hours
at
the
B,
the
shows
is almost findings
identical in
arthro-
of the
infants
orbicular
hip
with
the
and
of acetabular labrum, lateral
medium,
latest.
FINDING5
medium
around
contrast
chil-
roof puddle zone,
and of
ring
medium
medial
and
as a whole. Median
pooling.
as in the arthrosis,
initial and advanced stages as graded by the Japanese
thopaedic
Association,
tion
of
and
however, femoral always
the
as well
due
of Or-
pooling
can
terminal
stage
despite lateral head, a marked
found
osteophyte
to the
deviaretenpresence
the form of capital drop from acetabular bottom pooling usually tends to
in
double floor Median
decrease increase
In
the
pooling
prearthrosis
median
noted.
is not
margin.
In
median
to
ligament
distinctly
forms
lateral
transverse
of an
by by
abduction adduction
of the (Fig.
hip
joint
a the of Medicine,
91
Kyoto
to
University,
Kyoto,
Japan.
2,
1
and
and
B). the degree of centripetal position of the head to the acetabular socket, the state of pooling changes. When the opaque medium of median pooling shifts
According
medium
Faculty
and
of arthrosis, tion of the
contact
that
2
contrast
be
with bone in the joint cavity, it has frequently been found that the tip has not yet reached the joint cavity, due to the capsular thickening. Despite a strong resistance which may at first be encountered, the needle should be advanced further until a second strong resistance is felt. When the needle
joint.
of the
the femoral neck, and puddle of contrast medium medial and lateral to the transverse ligament are observed in arthrograms of the hip. Puddle of
that the injection does joint, the procedure is fluoroscopy. The needle
greater trochanter and until strong resistance below the femoral head. the
contrast
causes
intracapsular
is subject occurs to
and
Cartilages head,
contrast
of
of
in osteoarthritis
arthrographic
Kyoto arthrogout for factors
the
result
pain relief
/1
I,
Injec-
passing with the absorpmedium; however, the
findings
of an adult
De-
osteoarthritis
significant
osteoarthritic
earliest,
Figure
METHOD
76
the
graphic
attention.
Urografin
at
a rise
ARTHROGRAPHIC
dysplasia
partment of Orthopaedic Surgery, University Hospital, preoperative raphy has usually been carried operative
utes
cent of the been used
1968,
the
as the
capsule.
frequently
to
of the and
osteoarthritis
8o per has rarely
ml.
due
usually transient, tion of the contrast
angle in aceis the pro-
acetabular
than
in the
than
pain
pressure
irreducible
HIP*
M.D.
is indeed
has become an indispensable test in the treatment of congenital dislocation of the hip in infants and children, especially rethe cartilaginous acetabular tabular dysplasia, arthrography cedure of choice. In general, when treating
THE
JAPAN
done by dislocaappeared
this
OF
S. Tanaka,
92
T. Ito
and
K.
Yamamoto
MAY,
1975
C
American Journal of Roentgenology 1975.124:91-95.
E
0 FIG.
(A
i.
B)
and
acetabular
Schematic
roof;
E=orbicular
drawing
B=cartilage
zone;
and
an
of femoral
F=ring
of contrast
arthrogram
head;
of
initial
C=labrum;
medium
around
stage
of
the
femoral
pooling
neck;
A
osteoarthritis.
D=lateral
cartilage
=
of contrast
of
medium;
G=puddle of contrast medium I = puddle of contrast medium on J = subcapital puddle of contrast
on the medial side of the transverse ligament; H = transverse ligament; the lateral side of the transverse ligament; G and I form median pooling; medium.
laterally the fit
due of
to abduction
the
abduction,
in
dian
pooling
many
an
indication
Arthrography
should
onstrate is
the
state
difficult
roentgen
arthrographic strated
roentgenograms.
this
joint
In
on
prearthrosis articular
to dem-
when type
of
functional
and cartilage
as is evident from This is well demon-
findings. in
space
the
in
at at
ready
the
stage
this the
of
degenerates
Even bearing
disappeared,
joint
or the
known
better
the
cartilage potential
at
of adduction
hip
functional
and
irregularity
of
joint has al-
wear
adjacent
of
portion area
in
its
usually
the
of
bearing
b
3). In case joint,
the
for required.
accomplished
impossible
when portion
surgery,
indications surgery
is
degree
weight
before the of
and
Osteotomy
stage. weight
only on the weight on the adjacent
conventional
advanced
done space
termine the type
the
maintained,
decreases.
out
pooling,
the
cartilage
thickness
be
determine based
pro-
arthrosis,
osteotomy.
of median
7oint cartilage. In initial stage of arthrosis, is sufficiently
fre-
thus
valgus
by congruity studies alone.
osteotomy
congruity
adduction, be carried
to
to
hand, mecases due to
some
for
joint, due
indicating
other
time,
by
improves
viding
the in
this
At
hip
improves
instances
On decreases
adduction. quently
of the
also
osteotomy.
varus
it
joint
should
order
this
to
repair
This
de-
and can be
arthrography
(Fig.
contracture
of the
roentgenography
arthrography the
articular
bearing
part.
of the
adjacent
part
of the
cartilage
will
is
reveals cartilage
portion,
When
the
is intact,
usually
the not
but
also
cartilage
regeneration
take
place
after
American Journal of Roentgenology 1975.124:91-95.
VOL.
No.
124,
Arthrography
I
in Osteoarthritis
pooling
osteotomy. ing
In cases
of the
area,
joint
resulting
with
of the
weight
bearing
in
exposure
of
subchon-
an
bone,
regeneration
not
usually
occur, is the for
narrow-
space
dral
arthrodesis Indication
extensive
increases
of
and
cartilage
surgery osteotomy
by adduction,
decide reduction
does
arthroplasty
or
and
whether is
labrum
in
consists
of
initial
the
original
when the congruity of the joint is improved by abduction or adduction of the hip joint as viewed on conventional roentgenograms; (2) when arthrograph reveals change of median pooling by abduction or adduction of the hip joint, and also shows intact cartilage of the new weight bearing portion after osteotomy.
the
acetabular
roentgen
findings
ilcetabular ular
labrum
that
observed
While pediatrics tilaginous
this
is
as
labrum.
in in
Presence
infants
the acetabular
(i)
of an
arthrography
procedure for
follows:
is
and is
of
small
similar
in of
and
to
children.
significance
measurement
angle
acetab-
in order
car-
to
93
decreases
by abduction.
a factor disturbing the significance
osteoarthritis the
of
length
(Fig.
is carried
out
stage
of
basis
Hip
or not present,
tabuloplasty or
of choice. on the
of the
of
the 4). for
labrum
\Vhen
the
roof
of
simply ace-
prearthrosis
arthrosis,
acetabular
hip
to
length
the
of
end
is important.
of
When
a new acetabular roof is prepared beyond the length of the acetabular labrum, pressure against the new acetabulum is different either in the presence and absence of acetabular
labrum,
occasionally the edge. rum
and
cystic
change
or
fracture-like changes occur at Resection of the acetabular lab-
would
result
buffer
mechanism
pared
acetabular
femoral
head
in
disappearance
at
this
site
of and
the
the pre-
roof may compress the to accelerate changes of degenerative arthritis of the hip. Resection of the acetabular labrum should therefore be avoided.
S. Tanaka,
94
T.
Ito
and
K. Yamamoto
it.
The
MAY,
reasons
were:
when utilizing osteoarthritis,
arthrography tion of the an
hip
operative
with
can
accuracy
and
findings,
as applied compared
often
based
functional
be
on
roentgen
difficult to decide ure based on these
carried for
as
prearthrosis
arthrosis,
American Journal of Roentgenology 1975.124:91-95.
an
When
out.
and
vanced
stages
findings
are
on
auxiliary
of
procedand then
procedure
acetabuloplasty and the initial for
arthrosis,
indeed
of where and
conventional
of the it is
when
operative alone,
osteotomy
terminal stage, loss of joint space served
on the findings
made
convenstudies.
In many patients with osteoarthritis hip, however, there are instances
arthrography
to to
used for congenital dislocain pediatrics; (2) decision for procedure
relative
tional
definite
(i)
arthrography are lacking,
1975
is
is done stage of
initial
or
ad-
In
the
arthrographic
great
value.
there is extensive joint cartilage as obroen
tgenograms,
DISCUSSION
To
evaluate
arthritis
the
of the
hip
symptoms and
make
of
osteo-
a decision
as
the adequate operative procedure required, the clinical picture such as pain, ability to walk, joint mobility, activities of daily living as well as the roentgenograms should be studied.9”3 It is sometimes difficult to evaluate the disease based on clinical and roentgen studies alone, and at this time the operative procedure itself has to to
be
carefully
cumstances, clearance should carried surgery.
considered procedure
preoperative
considered.
Under
such
cir-
an auxiliary method such as of radioisotopes from the joint be used.’2 As a rule, arthrography is out
in
In
the
to in
patients past,
be
hospitalized arthrography
a necessary
osteoarthritis
investigation
for was
not
preoperative the hip, and did not include of
FIG. 4. Acetabular
labrum with acetabular dysplasia. The new acetabular roof should be made so as to cover the acetabular labrum.
VoL.
No.
124,
Arthrography
i
arthrography tients
is not
over
terminal
50
years
stage
years
of
age
with
plus
intense
of
range
of
or
pain,
preclude
any
greatest
In
of
ar-
stage
marked
motion
o
and
decrease giant
cystic
head or acetabureplacement is is eliminated to
additional
risk
complication
of infection-
of
total
hip
re-
2.
4.
6.
done on patients to remedy osteo-
of the
hip
in os-
are
not
so significant
8.
vary
dislocation of the hip of and children, nevertheless this is a method since arthrographic findings at each stage and can be compared
with
the
infants useful
congenital
clinical
picture
and
patients
tabuloplasty, nificance and
requiring
osteotomy
or
K.
NAKAMURA,
SEVERIN,
E.
location
of
9.
this method is of great sighas proved entirely adequate.
Tanaka,
II.
evaluation Orthop.,
J.
Ohara English 14.
mit
der
Arthrographie
V.
Unsere der
Erfahrungen Behandlung
der
K.
128
Bone
& Joint
RAD.
hip:
analyses.
1973,
correlation
Cent.
15,
345-354.
of
M. Studies congenitally Studies
normal
hip
J.
Orthop.
&
THERAPY
zi8, 870-875. ITO, T., SHINAGAWA, Y. Computer analysis
ponent
Surg.,
K., and ToRIof technetium pertechwith arthrosis deformans.
joint
arthritic
hip.
1-1286.
ROENTGENOL.,
S.,
I.
of
45, 813-833. reduction in congenital
HAMAMOTO,
Clearance
MED.,
Y05HIzUMI,
osteoarthritis
and ITO, ‘F. Clinical for osteoarthritis of hip. Clin.
20,
from
TANAKA,
Jap.
1971,
of hip. J. 363-371. M0RI, E.,
1969,
J.
ture Part
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reduction
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velopment
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roentgen findings. Thus arthrography is useful to assess the total disease picture and to decide on the operative procedure required. In
of open
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in
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CONCLUSION
American Journal of Roentgenology 1975.124:91-95.
R. roof in fetal logical study.
trastfullung
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95
Dysplasie
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47-A, 3. LEvEUF,
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as
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Ztschr. Orthop.,
of
over
of the kongenitalen
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in
lum, total indicated.
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the
of
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in Osteoarthritis
on
joints
principal
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strucjoints. of
