This document discusses imaging techniques for evaluating Developmental Dysplasia of the Hip (DDH), including radiography, CT, MRI, ultrasound, and arthrography. Key imaging findings are described, such as the Hilgenreiner's line, Perkin's line, Tonnis grading of hip dysplasia, Andren von Rosen line, acetabular index, Shenton's line, CE angle of Wrisberg, alpha and beta angles on ultrasound, and the Kashiwagi classification on MRI. The document provides an overview of the anatomy and measurements used to classify and assess the severity of DDH.

1. Developmental Dysplasia of Hip
Imaging
DR. DITESH JAIN
DEPT OF ORTHOPEDICS
LHRC

2. DDH Radiology
 Radiograph
 Computerised Tomography
 Magnetic Resonance Imaging
 Ultrasonography
 Arthrogram

3. Hilgenreiner`s Line
Horizontal line joining the uppermost
aspect of tri-radiate cartilage on both
sides.
Perkin`s Line/Ombredanne Line
Line drawn perpendicular to
Hilgenreiner`s line drawn lateral to
Actabular margin & divide the hip in
four quadrents.
Hip Quadrants:
Lower Inner: Normal
Upper Inner: Subluxated Hip
Lower Outer: Dislocated Hip
Upper Outer: High Dislocation
Tonnis Grading of Hip Dysplasis
Grade 1 : Medial to perkins Line
Grade 2: Lateral to perkins line below
superior acetabular margin
Grade 3: Lateral to perkins line at the
superior acetabular margin
Grade 4: Lateral to perkins line above
superior acetabular margin

4. Von Rosen View: 45 deg ABD with INT
rotation
Andren Von Rosen Line:
Normal: passes through or
just above tri-radiate cartilage.
Dislocated: goes above the
iliac spine.

5. Acetabular index & Shenton`s Line
 Acetabular index : Acetabular
inclination in respect to horizontal,
Normally < 30 deg.
 Shenton`s Line: curved line begins at
lesser trochanter to upper border of
obturator foramen along lower
border of femoral neck.

6. CE angle of Wrisberg:
Junction of perkin line and Line connecting
lateral margin of aetabulum to center of
femoral head.

8. Ultrasound : Screening, Diagnosis and Follow Up

10. Alpha angle: Between baseline and
roof line
Beta angle: Between Baseline and
cartilage or labrum roof line.
FHC: Represent femoral head
centricity as baseline should bisect
head of femur

12. Arthrogram
 Good tool to assess reduction,
acetabular depth.
 Stability after reduction:
 Width of medial dye pool,
 Fair reduction if 5-6mm
 > 6 mm poor eduction

13. MRI
 Kashiwagi Classification:
 Group 1: Sharp actabular rim & reducuble with pavlik harness
 Group 2 : rounded acetabular rim with almost reducible with pavlik harness
 Group 3 : Inverted acetabular rim with non reducible with pavlik harness

14. CT scan
 Rarely indicated
 For noncentric reduction or difficult to evaluate radiographs (hip in spica cast)

15. Thank You