Limited Effectiveness of Sonography in Revealing Hip Joint Effusion: Preliminary Results in 21 Adult Patients with Native and Postoperative Hips
Patrick N. Weybright1,
Jon A. Jacobson1,
Kristyn H. Murry1,2,
John Lin1,3,
David P. Fessell1,4,
David A. Jamadar1,
Mohammed Kabeto5 and
Curtis W. Hayes1
1 Department of Radiology, University of Michigan Medical Center, 1500 E.
Medical Center Dr., Ann Arbor, MI 48109-0326.
2 Present address: Department of Radiology, St. Joseph Mercy Health System, 5301
Huron River Dr., Ann Arbor, MI 48197.
3 Present address: Valley Radiologists, Ltd., 5322 W. Northern Ave., Glendale,
AZ 85301.
4 Present address: Akron Radiology Inc., 525 E. Market St., Akron, OH
44304.
5 Center for Health Outcomes, Innovation, and Cost Effectiveness Studies, 3A-14,
300 N. Ingalls Bldg., Ann Arbor, MI 48109.

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Fig. 1. 78-year-old woman with native hip and infected joint
effusion. Anterior sonogram obtained longitudinal to femoral neck shows 5 mm
of anterior recess distention. Three milliliters of anechoic fluid
(arrow) was aspirated with sonographic guidance and found to be
infected. Note normal anterior and posterior layers of anterior joint capsule
(arrowheads). H = femoral head, N = femoral neck.
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Fig. 2. 26-year-old woman with native hip and no joint effusion.
Anterior sonogram obtained longitudinal to femoral neck shows 6 mm of
hypoechogenicity (arrows). No fluid was present at fluoroscopic
aspiration. H = femoral head, N = femoral neck.
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Fig. 3. 20-year-old woman with native hip and no effusion and
probable synovitis. Anterior sonogram obtained longitudinal to femoral neck
shows 25 mm of hypoechoic anterior recess distention (arrows).
Internal arterial flow was identified with Doppler waveform (not shown). No
fluid was present at fluoroscopic aspiration. H = femoral head, N = femoral
neck.
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Fig. 4. 36-year-old woman with hip arthroplasty and no joint
effusion. Anterior sonogram obtained longitudinally to femoral neck prosthesis
shows 7 mm of hypoechogenicity (straight arrows) over neck (N) of
prosthesis and 6 mm of hypoechoic distention of pseudocapsule (curved
arrow) over native femur (F). No fluid was present at fluoroscopic
aspiration. Note reverberation artifact from metal prosthesis
(arrowheads). H = head of prosthesis, A = acetabulum.
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Fig. 5. 66-year-old woman with hip arthroplasty and joint effusion.
Anterior sonogram obtained longitudinally to femoral neck prosthesis shows 7
mm of hypoechogenicity (straight arrows) over neck (N) of prosthesis
and 3 mm of hypoechoic distention of pseudocapsule (curved arrow)
over native femur (F). Joint fluid was present at fluoroscopic aspiration.
Note reverberation artifact from metal prosthesis (arrowheads). H =
head of prosthesis, A = acetabulum.
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Fig. 6A. 36-year-old man with hip arthroplasty and extraarticular
extension of joint effusion. Anterior sonogram obtained longitudinally to
femoral neck prosthesis shows 25 mm of hypoechogenicity (straight
arrows) over neck (N) of prosthesis and 10 mm of hypoechoic distention of
pseudocapsule (curved arrow) over native femur (F). Joint fluid was
present at sonographic aspiration. Note reverberation artifact from metal
prosthesis (arrowheads).
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Fig. 6B. 36-year-old man with hip arthroplasty and extraarticular
extension of joint effusion. Anterior sonogram longitudinal to femoral neck
prosthesis shows extraarticular extension of joint effusion (curved
arrow). Note reverberation artifact from metal prosthesis
(arrowheads). Straight arrows indicate hypoechogenicity over femoral
neck (N).
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Copyright © 2003 by the American Roentgen Ray Society.