If you visit the doctor to learn if you have hip dysplasia, X-rays will be the first tool the doctor will use. An X-ray works the same way as a photo negative -- the areas containing calcium, such as bones, show up in white, and the areas containing water, such as cartilage, show up in black. The X-ray will show any abnormalities by profiling the anterior of the acetabulum. While X-rays by themselves are not accurate for hip dysplasia diagnosis, they give doctors a good method to track the progress of the hip during treatment.
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Like X-rays, the other tools used to diagnose hip dysplasia in adults are noninvasive and painless. One is a computer tomography scan (CT scan). A CT scan produces multiple pictures of internal organs, soft tissue and bone with more clarity than conventional X-ray machines. These pictures can then be joined together by a computer to create cross-sectional views of the area of interest. In hip dysplasia, a CT scan, also known as a CAT scan, allows the doctor to determine how far the femur tips forward. This is called the degree of femoral anteversion. The CAT scan also lets the doctor see how well the acetabulum covers the back of the femur, known as acetabular coverage.
In a three-dimensional computer tomography scan (3-D CT scan), a computer takes the X-ray slices of the area being studied and combines them into 3-D images. These images can be rotated so a doctor can see the hip from any direction. This method is beneficial for hip dysplasia patients, since it allows the doctor to visualize the overall shape of the acetabulum for diagnosis or surgery planning.
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Another tool is magnetic resonance imaging (MRI), which is able to visualize the underlying bone and soft tissue anatomy in any plane or angle with greater contrast than a CT scan. An MRI arthrogram adds a contrast or radiology dye to the MRI process in order to acquire better images of a joint. An MRI arthrogram is done in two parts. First, the patient lies on an X-ray fluoroscopy table, which provides real-time X-ray images to guide the radiologist as he or she injects contrast solution into the joint. The doctor can also move the hip around during the arthrogram to help detect tears to the labrum and assess the mobility of the hip and its reducibility, or potential to be corrected. However, this is not always done during an arthrogram -- it depends on what your surgeon has ordered to be tested. This stage roughly takes 30 minutes to complete. The patient is then taken to the MRI scanner for the rest of the procedure.
Once the doctor has evaluated all the medical images, he or she can make a diagnosis. The recommended course of treatment varies considerably based on whether the patient is a baby or an adult, among other factors. On the next two pages, we'll explore how doctors treat hip dysplasia noninvasively, beginning with treatment in children.
Many people who have been diagnosed with hip dysplasia have shared their experiences with other patients through blogging. Here's a sample: