Congenital Hip Dislocation with a Genu Recurvatum in Togo: A Case Report

Introduction: CHD is a condition, which is frequent in pediatrics in the Caucasian population, remains rare in the Black population, and exceptional in sub-Saharan Africa. The Patient: We report this first Togolese case of bilateral congenital dislocation of the hip associated with genu recurvatum observed in a newborn received on the second day of life. The Primary Diagnoses, Interventions, and Outcomes: The pediatric examination had noted extension of lower limbs. The thighs were in adduction with a stiff bilateral genu recurvatum. The abduction of the thighs on the pelvis was considerably limited. The Barlow and Ortolani maneuvers showed a protrusion. There was also a camptodactyly of the thumbs and a cleft palate. The rest of the examination was normal. Ultrasound of the hip showed a bilateral congenital dislocation of the hip with an estimated acetabular fundus of 7 mm on both the right and left sides. Ultrasound and radiography of the knees were normal. Conclusion: Clinical examination at birth is the key step in diagnosis of congenital hip dislocation. In situations where diagnosis is difficult, ultrasound is of capital importance. Treatment is in the majority of cases orthopedic.

THU0602 EXTENDED BONE HYDATIDOSIS IN THE HIP AND FEMUR WITH EXTENSION TO THE SOFT PARTS: A CASE REPORT

Background:Osseous hydatid cyst is an uncommon disease with weak response to treatment.hydatid disease should be included in the differential diagnosis of cystic lesions of bone in endemic regions. Bone cysts account for only 0.5 to 2.5% of all hydatid cysts in humans.Objectives:To report a case of osseous hydatid disease extended on hip and femurMethods:We report a case of osseous hydatid diseaseResults:A 49 YEAR OLD BRICKLAYER, with no past-medical history and no animal contact, was admitted to our department for a left hip pain. the patient was apyretic and in a good general health condition. He had a very painful walk. the mobilility of the left hip joint was very painful and restricted.The pelvis X-rays showed osteolytic lesions in the ischiopubic branch and in the left femur and proximal extremity of the tibia.The C-Reactive protein value, the protein electrophoresis were normal. tumor markers test was negative.An ultrasound of the hip showed a low abondance intra-articular effusion. The Pelvic MRI showed multilocular appearance extending over the bone and muscle with breach of the bone cortex of the femur very suggesting of the diagnosis of a bony and muscular echinococcosis.NO other localization of hydatidosis were detected, body ct scan was normalConclusion:Hydatid disease occurs worldwide and mainly associated with sheep farming. The liver and lungs are the most common locations. Bone cysts are uncommon but severe. Although immunofluorescent assays are useful, the final diagnosis depends on histology. The treatment is almost surgery. Recurrence is commonDisclosure of Interests:None declared

The use of pelvic radiographs as a predictor for gluteal tendinopathy and bursitis

Aim: To evaluate the relationship between radiographic measurements of the hip and sonographic evidence of gluteal tendinopathy and bursitis in patients with lateral hip pain. Methods and materials: Patients with lateral hip pain referred for ultrasound of the hip in our institution over a 5-year period were identified. Findings of gluteal tendinopathy and subgluteal or trochanteric bursitis on ultrasound were recorded. Radiographs of the hip were also evaluated and femoral offset (FO), global offset (GO), abductor lever arm (ALA) and trochanteric impingement distance (TID) were recorded. The mean of each measurement was compared between patients with gluteal tendinopathy and subgluteal or trochanteric bursitis. Results: 273 patients were included in the study. 107 patients (39.2%) had a THA. In the asymptomatic hip, a range of normal measurements were obtained: FO 22.4–76.5 mm, GO 40.1–116.1 mm, ALA 45.0–98.4 mm and TID 13.8–63.1 mm. In the native hip and post THA, there was no statistically significant relationship between FO, GO, ALA and TID in patients with gluteal tendinopathy or trochanteric or subgluteal bursitis. Conclusions: Lateral hip pain is a common presenting complaint in patients with hip pain and is reported in a small proportion of patients post THA. No statistically significant relationship was found between radiographic measurements and ultrasound findings in our patient cohort. However, we describe the range of measurements obtained from the normal asymptomatic hip in this large cohort of patients, which may aid in the evaluation and management of patients with lateral hip pain.

Ultrasound of the Hip and Thigh

Chapter 123 discusses US of the hip and thigh. US scanning of the hip and thigh is frequently used in evaluation of hip joint effusions and synovitis; common tendon pathology about the hip and pelvis, including the gluteal, hamstring, iliopsoas, and adductor tendons; muscle injuries; and in evaluation of hip bursae such as the iliopsoas and trochanteric bursae. Dynamic US evaluation may identify the etiology of a “snapping hip,” which has a number of potential etiologies. US examination may be comprehensive or focal. A patient-guided examination in the area of focal symptoms may help in identification of subtle pathology.

Ultrasound of the Hip Joint, Soft Tissues, and Nerves

Ultrasound (US) of the hip is widely used both in children and adults for selected clinical indications. According to the European Society of Musculoskeletal Radiology, hip US is indicated for several clinical conditions involving the joint, soft tissues, and nerves. Hip US indications include fluid detection, synovitis, effusion, and synovial cysts; soft tissue evaluation such as tendinopathy and bursitis; and peripheral nerve pathology of large and small nerves around the hip. In addition, US is an effective imaging modality to guide interventional procedures. This article provides a brief overview of the US scanning technique of the hip and presents some common and less common conditions in which US of the hip is usually performed in adult patients.