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Ultrasound of the hip joints with osteoarthritis
Last reviewed: 28.11.2021
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Although MRI is the leading method for the detection of coxarthrosis , ultrasound has the advantage of detecting a small effusion in the hip (even less than 1 ml), as well as disturbances in the condition of the periarticular soft tissues in the early stages of osteoarthrosis. The study is carried out using a linear or convective sensor in the range 3.5-7 MHz, depending on the constitutional characteristics of the patient.
The test is usually done from the front access (longitudinal and transverse position of the sensor), in the patient's position on the back with straight legs. Bony landmarks are the upper edge of the acetabulum and the semicircle of the head of the femur. From the anterior access, hypoechoic hyaline cartilage, synovial articular hip joint capsule (represented by fibers of the sciatic-femoral, pubic-femoral and iliac-femoral ligaments) are well visualized. To visualize a large trochanter and a sternum bag, located above it superficially subcutaneously, lateral access is used. The sciatic is explored from the back access in the patient's position lying on its side with the limb being bent and brought to the stomach.
In one study, 54 patients with osteoarthritis of the hip joints (diagnostic criteria AC R, 1990) underwent ultrasound at the age of 41 years - 74 years (mean age 56.44 + 7.12 years); of them men - 22, women - 32, the duration of the disease was 0.6 years - 37 years (on average - 8.3 ± 3.48 years).
The presence of effusion in the hip joint was diagnosed under the condition that the distance between the surface of the femoral neck and the joint capsule exceeded 9-10 mm.