X-ray Findings in Developmental Dysplasia of Hip (DDH)
Important X-ray Findings
Acetabular Changes
Increased acetabular index
Shallow acetabulum
Increased acetabular slope
Poor superolateral coverage of femoral head
Femoral Head Findings
Lateral and superior displacement of femoral head
Disruption of Normal Lines
Hilgenreiner Line
Horizontal line through triradiate cartilages
Femoral head should lie below this line
Perkin Line
Vertical line drawn perpendicular to Hilgenreiner line at lateral acetabular edge
Femoral head should lie in inferomedial quadrant
Shenton Line
Smooth arc formed by inferior femoral neck and superior obturator foramen
Broken/disrupted in DDH
Quadrant Position
Femoral head displaced into superolateral quadrant
Other Findings
Increased femoral neck anteversion
Valgus neck-shaft angle (coxa valga)
Secondary pelvic asymmetry in unilateral cases
Important Angles
Acetabular Index
Acetabular Index<25 after infancy Increased in DDH Normally decreases with age Classic Radiographic Signs Empty acetabulum Lateralization of proximal femur Delayed ossification of femoral head



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