1. Anne Connell Mater Children’s Hospital AP PELVIS Only a simple film but an important one! Anne Connell Mater Children’s Hospital

2. Anne Connell Mater Children’s Hospital The hip is a ball and socket joint. The ball is the femoral head and the socket is the acetabulum. At birth, the femoral head and the acetabulum are made of mostly cartilage and are relatively soft. For the joint to form properly, the femoral head and acetabulum must be orientated correctly. DDH is a progressive condition in which this does not happen. The term encompasses many abnormalities, from mild under-development of new born hips to the stiff unreducible hip. Imaging U/S up to 4-6mths until femoral heads ossify

3. Anne Connell Mater Children’s Hospital The Hilgenreiner Line is a horizontal line drawn through the top of the triradiate cartilage.

4. Perkins Line is a vertical line through the most lateral ossified margin of the roof of the acetabulum perpendicular to Hilgenreiners Line. The ossification centre of the femoral head should be located in the medial lower quadrant of the line intersection. Mater Children’s Hospital

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12. Anne Connell Mater Children’s Hospital NAPPIES !!!!

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18. Anne Connell Mater Children’s Hospital 18 Months old parents noticed asymetrical walk NO PAIN Active child who had an odd crawl Dislocated hip Delayed femoral head ossification centre Significant acetabular dysplasia

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21. Anne Connell Mater Children’s Hospital TRAUMA TRAMPOLINE INJURY

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24. Anne Connell Mater Children’s Hospital SUFE or SCFE Usually 11 to 15 year old (mostly males) Pain in hip Limp Often also pain in knee May have no history of trauma

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31. Anne Connell Mater Children’s Hospital FIVE THINGS TO REMEMBER

32. Anne Connell Mater Children’s Hospital MANY THANKS TO Kerry Carapeto for sharing her pelvis DDH research Ivan Simic for computer assistance Gerard Duckworth for photo assistance Kelly Paterson for CP information Lisa and her lovely daughter Addison for photographs Fiona for modelling her feet photos

33. Anne Connell Mater Children’s Hospital Concensus Statement for Hip Surveillance for children with CP Standards of care 2008 Wheeless Textbook of Orthopaedics www.pediatric-orthopedics/DDH F Gaillard Images from from Radiopedia References