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AJR 2000; 174:1629-1634
© American Roentgen Ray Society

Doppler Sonography of the Anterior Ascending Cervical Arteries of the Hip

Evaluation of Healthy and Painful Hips in Children

Simon G. F. Robben1, Maarten H. Lequin1, Ad F. M. Diepstraten2, Wim C. J. Hop3 and Morteza Meradji1

1 Department of Pediatric Radiology, Sophia Children's Hospital, University Hospital Rotterdam, Dr. Molewaterplein 60, 3015 GJ Rotterdam, The Netherlands.
2 Department of Pediatric Orthopedic Surgery, Sophia Children's Hospital, University Hospital Rotterdam, 3015 GJ Rotterdam, The Netherlands.
3 Department of Epidemiology and Biostatistics, Erasmus University, Dr. Molewaterplein 50, Rotterdam, The Netherlands.

OBJECTIVE. We evaluated the Doppler sonography of small feeding arteries to the femoral head in children.

SUBJECTS AND METHODS. In a prospective study of 224 hips in 112 patients (mean age, 5 years 11 months), the anterior ascending cervical arteries of the hip were identified with color Doppler sonography. Subsequently, we measured the resistive index (RI) with pulsed Doppler sonography.

RESULTS. In 61% (137/224) of hips, a Doppler signal could be obtained. In asymptomatic hips (n = 64), the mean RI was 0.58. In symptomatic hips, the definitive diagnoses and mean values of RI included transient synovitis (n = 31) and 0.92, Perthes' disease (n = 9) and 0.67, and miscellaneous (n = 5) and 0.68. In 28 symptomatic hips, no definite diagnosis could be determined and the complaints spontaneously disappeared during follow-up (mean RI, 0.57). We found no statistically significant difference in the RI of symptomatic versus asymptomatic hips, except in patients with transient synovitis (p < 0.001). In 11 hips with transient synovitis that were reexamined after 4-6 weeks, the RI returned to normal (0.57). The RI in symptomatic hips showed a positive correlation with the amount of effusion (r = 0.69, p < 0.001). In symptomatic and asymptomatic hips, we found no correlation with age (p = 0.9 and 0.1, respectively).

CONCLUSION. The deep capsular vessels of the hip joint can be evaluated on Doppler sonography in more than 60% of hips. Also, the RI is age independent and correlates with the amount of effusion.


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