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Ultrasound signs of diseases of the hip area
Last reviewed: 19.10.2021
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The main task of the ultrasound doctor is to conduct differential diagnostics between intraarticular and extraarticular pathologies. Intraarticular pathological conditions include: effusion into the joint cavity, synovitis, deforming arthrosis, aseptic necrosis of the head of the femur.
Exudation in the joint cavity, synovitis.
The presence of effusion in the hip joint is diagnosed with ultrasound if the distance between the surface of the femoral neck and the joint capsule exceeds 9-10 mm. When synovitis, as a rule, a thickening of the joint capsule is observed. Therefore, it is important to evaluate the symmetry of the thickness of the joint capsule with a healthy side. A difference of more than 1-2 mm indicates a pathology of the synovial articular bag. Ultrasonic examination is also used to detect fluid around the prosthetic hip joint or after osteosynthesis. With CT or MRI, often metal prostheses cause artifacts that interfere with the correct assessment of the presence of fluid in the cavity or around the joint.
Osteochondromatosis and articular mouse.
Foreign fragments can appear in the synovial articular bag with fractures, tearing of bone or cartilage structures, osteoarthritis, osteochondromatosis. Fragments enter the articular space, forming a "joint mouse". The articular mouse with ultrasound is, as a rule, an intraarticular mobile hyperechoic structure.
Nesroshshie fractures and false joints.
All factors leading to a delayed fusion of fragments, if the necessary measures are not taken, can lead to the formation of false joints. False joints are observed after osteosynthesis of closed fractures of the hip diaphysis, if the operation is complicated by suppuration, osteomyelitis. With ultrasound examination, it is possible to identify false joints by the presence of intermittent bone contours and uneven bone calluses with a defect; Distal acoustic shade behind bone structures at the site of formation of false joints. As a rule, around there is a zone of perifocal inflammation with a pronounced vascular reaction.
Aseptic necrosis of the head of the femur.
The disease refers to severe hip joint pathology, which affects mainly men, lasts for a long time and leads to persistent disability and disability reduction. Often manifested complication after any trauma to the hip (dislocation, bruise), in most cases is formed after a fracture of the neck of the hip.
Clinically in the early stages it is manifested by pain in the joint, atrophy of the muscles of the thigh and lower leg, restriction of movements in the joint, and violation of the gait. At ultrasound examination in the early stages of significant changes are not detected. Sometimes it is possible to detect a reactive effusion in the joint cavity. In the future, the symmetry of the contours of the hip joint is broken. The joint gap narrows. The contours of the head of the femur become uneven.
Due to constant trauma, the capsule of the joint thickens, synovitis is observed.
Prosthetic hip joint. Ultrasound research helps in identifying early and late postoperative complications in hip replacement, such as infection, hematoma and intra-articular effusion. After metalloprosthesis, the ultrasound method becomes the single most sensitive of all radiation methods for revealing the pathology of soft tissues and effusion in the joint cavity.