Dynamic ultrasound assessment of hip instability and anterior and posterior hip impingement

• Published in: Skeletal radiology Vol. 52; no. 7; pp. 1385 - 1393
• Main Authors: Sahr, Meghan E., Endo, Yoshimi, Sink, Ernest L., Miller, Theodore T.
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01-07-2023; Springer; Springer Nature B.V
• Subjects: Diagnosis; Dynamic stability; Femoracetabular Impingement - diagnostic imaging; Femoracetabular Impingement - surgery; Hip; Hip Joint - diagnostic imaging; Hip Joint - surgery; Humans; Imaging; Impingement; Medical imaging; Medicine; Medicine & Public Health; Nuclear Medicine; Orthopedics; Pathology; Physical Examination; Radiology; Reliability analysis; Reproducibility of Results; Stability analysis; Surgeons; Ultrasonic imaging; Ultrasonic methods; Ultrasonic testing; Ultrasonography; Ultrasound; Hip preservation; Impingement; Microinstability; Femoroacetabular impingement; Ischiofemoral impingement; Dynamic ultrasound; Hip
• ISSN: 0364-2348; 1432-2161
• DOI: 10.1007/s00256-022-04264-6

Objective
In this technical report, we describe our protocol for the dynamic sonographic evaluation of the hip and assess reliability of the ultrasound assessment of hip microinstability.
Materials and methods
Our clinical experience with a standardized dynamic ultrasound of the hip performed in a series of 27 patients with imaging performed by an experienced musculoskeletal radiologist during physical examination by an orthopedic surgeon specializing in hip preservation is illustrated with clinical photographs and ultrasound images from volunteers and selected patients. Interrater reliability for the diagnosis of microinstability was calculated.
Results
Dynamic ultrasound technique and findings of hip instability, femoroacetabular impingement, and ischiofemoral impingement with corresponding clinical photos showing the necessary physical examination maneuvers are described. Interrater agreement for the diagnosis of microinstability was substantial (
κ
0.606 [0.221–0.991]).
Conclusion
At our institution, dynamic ultrasound of the hip during physical examination complements information gathered from static imaging by providing real-time correlation of symptoms with what is occurring anatomically.