Lateral Uncovering Of The Femoral Head

Hip Femoral Head Gauge
FIGURE 3.28. AP radiograph of the right hip of a 50-year-old woman, demonstrating classic characteristics of acetabular dysplasia.
Hip Dysplasia Symptoms Women
FIGURE 3.29. AP radiograph of the right hip of a 24-year-old woman with mechanical catching, suggestive of labral pathology. Signs of mild dysplasia include a slight valgus position of the femoral neck and slight lateral uncovering of the femoral head.
The Femoral Head Weight Bearing

FIGURE 3.30. AP radiograph of the left hip of a 20-year-old collegiate basketball player with mild long-standing activity-related hip pain. There is subtle joint space narrowing in the superior weight-bearing portion of the hips and malformation of the femoral head that is distinct, but not classic, for the common developmental disorders of the hips.

FIGURE 3.30. AP radiograph of the left hip of a 20-year-old collegiate basketball player with mild long-standing activity-related hip pain. There is subtle joint space narrowing in the superior weight-bearing portion of the hips and malformation of the femoral head that is distinct, but not classic, for the common developmental disorders of the hips.

The relationship of congenital hip dysplasia and labral pathology has been well defined.9,10 Severe dys-plasia carries a significant incidence of an inverted ac-etabular labrum (Figure 3.28). Milder degrees of dys-plasia, characterized by slight lateral uncovering of the femoral head, or slight valgus position of the femoral neck may be associated with milder degrees of labral disease (Figure 3.29). Additionally, subtle congenital or developmental changes such as those associated with mild Legg-Calve-Perthes disease or mild untreated slipped capital femoral epiphysis may be associated with symptomatic labral or chondral lesions in adulthood (Figure 3.30).

Traditionally, the single most definitive test for differentiating an intraarticular (or intracapsular) source of hip pain from an extraarticular source has been a fluoroscopically guided injection of anesthetic into the joint. Contrast is used to confirm the intracapsular position, followed by instillation of 8 to 10 ml bupivi-caine. Temporary alleviation of symptoms for several hours is usually indicative of intraarticular pathology. The potential for extravasation or communication with surrounding bursas precludes this test from being 100% reliable. However, lack of response to the injection should lead one to look elsewhere for the source of pathology. Also, for older patients with a principal diagnosis of degenerative disease, concomitant use of a solution containing corticosteroid occasionally provides protracted pain relief analogous to injection of an arthritic knee. Currently, with the development of gadolinium arthrographic techniques with magnetic resonance imaging (MRI) (MRA), this anesthetic injection test can now be combined with the contrast medium used for imaging. It is imperative for the treating surgeon to specify to the radiologist when performing MRA to be certain to include bupivicaine. Response to the anesthetic may provide more reliable information than the images.

References

1. Byrd JWT, Jones KS: Prospective analysis of hip arthroscopy with two year follow up. Arthroscopy 2000;16:578-587.

2. O'Leary JA, Berend K, Vail TP: The relationship between diagnosis and outcome in arthroscopy of the hip. Arthroscopy 2001;17:181-188.

3. Aufranc OE: The patient with a hip problem. In: Aufranc OE (ed). Constructive Surgery of the Hip. St. Louis: Mosby, 1962:15-49.

4. Hilton J: Rest and Pain. London: Bell, 1863.

5. Jacobsen T, Allen WC: Surgical correction of the snapping il-iopsoas tendon. Am J Sport Med 1990;18:1470-1474.

6. Allen WC, Cope R: Coxa saltans: the snapping hip revisited. J Am Acad Orthop Surg 1995;3:303-308.

7. Zoltan DJ, Clancy WG Jr, Keene JS: A new operative approach the snapping hip and refractory trochanteric bursitis in athletes. Am J Sports Med 1986;14:201-204.

8. Brignall CG, Stainsby GD: The snapping hip: treatment by Z-plasty. J Bone Joint Surg 1991;73B:253-254.

9. Dorrell J, Catterall A: The torn acetabular labrum. J Bone Joint Surg 1986;68B:400-403.

10. Klaue K, Durnin DW, Ganz R: The acetabular rim syndrome. J Bone Joint Surg 1991;73B:423-429.

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Responses

  • selassie
    What does slight uncovering of head of femur?
    2 years ago
  • Felicita
    What does minimal covering right femoral head mean for 2 year old?
    11 months ago
  • Leonardo Mancini
    What does lateral aspect of the femoral head mean?
    11 months ago
  • tuomo
    What does "with secondary uncovering of the right femoral head," mean?
    10 months ago
  • berylla
    What does it mean when there is a slight uncovering to the hips?
    10 months ago
  • luwam
    How to treat superior lateral migration of the femoral head in the acetabulum?
    7 months ago
  • Quarto Lori
    What does mild uncoverage of the right femoral head mean?
    5 months ago
  • senay aman
    What does lateral uncovering femoral head mean?
    5 months ago
  • Christian
    How much lateral uncovering of femoral head normal?
    4 months ago
  • ELISA
    Why is there uncovering of the acetabulum heads?
    4 months ago
  • Craig
    What does 20% of the talar head uncoverage mean?
    3 months ago

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