Key result
Timely diagnosis of developmental dysplasia of the hip, Legg-Calve-Perthes disease, and slipped capital femoral epiphysis using appropriate imaging modalities is crucial to prevent long-term morbidity.
Why the study?
Developmental hip disorders are common in pediatric and adolescent populations, requiring timely diagnosis and imaging to prevent complications that cause long-term morbidity and poor quality of life.
Ultrasonography and radiographs are the primary imaging modalities in the diagnosis of developmental hip disorders, with MRI and CT playing a supportive role in complex cases.
Review highlights imaging role in pediatric hip disorders; leaves open standardized protocols for DDH management.
Developmental disorders of the hip joint are common in pediatric and adolescent populations, and imaging plays a pivotal role in their diagnosis and follow-up. Timely diagnosis and appropriate management are crucial to prevent complications, which can lead to long-term morbidity and poor quality of life. This article outlines the relevant aspects of normal hip development and reviews the imaging considerations in the common developmental hip disorders – developmental dysplasia of the hip (DDH), Legg–Calve–Perthes disease (LCPD), and slipped capital femoral epiphysis (SCFE). DDH results from acetabular or femoral head dysplasia and affects neonates, infants, and toddlers. Ultrasonography is the workhorse of diagnosis in neonates and infants before epiphyseal ossification. Radiographs are used for diagnosis in toddlers and older children, while magnetic resonance imaging (MRI) plays a significant role in cases with diagnostic dilemma. LCPD affects young boys in the age group of 2–14 years and is characterized by idiopathic osteonecrosis of the femoral head. Radiographs and MRI play the major role in the diagnosis and staging of LCPD. Depending on the stage of disease, radiographs show epiphyseal flattening, fragmentation, metaphyseal hyperlucency, etc., on radiographs and there may be corresponding altered epiphyseal T1 signal intensity, with subchondral T2 hyperintensity and femoral head deformation on MRI. SCFE is a type I Salter Harris injury with epiphyseal slip, affecting adolescents (predominantly males). Radiographs and MRI are primarily used for diagnosis and reveal epiphyseal slip with physeal edema and joint effusion/synovitis. Timely identification and management of SCFE avoids complications such as avascular necrosis, femoroacetabular impingement, and secondary osteoarthritis.
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Subramanian et al. (2025) conducted a review in Developmental disorders of the hip (DDH, LCPD, SCFE). Diagnostic imaging (Ultrasonography, Radiography, MRI, CT) was evaluated. Timely diagnosis of developmental dysplasia of the hip, Legg-Calve-Perthes disease, and slipped capital femoral epiphysis using appropriate imaging modalities is crucial to prevent long-term morbidity.
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