Pediatric Radiology

, Volume 26, Issue 9, pp 629–634 | Cite as

Ultrasonographic evaluation of the anterior recess in the normal hip: A prospective study on 166 asymptomatic children

  • Wiltrud K. Rohrschneider
  • Gabriele Fuchs
  • Jochen Tröger


Purpose. To redefine the ultrasonographic features of the normal hip joint in children and to establish a normal value for the neck-capsule distance (NCD) of its anterior recess.Materials and methods. 332 hips of 166 asymptomatic children were examined sonographically. In a sagittal section plane the maximum distance between the anterior surface of the femoral neck and the anterior limit of the articular capsule (NCD-A) was measured.Results. The hypoechoic synovial membrane occupying the anterior recess could always be differentiated from the capsule. An additional thin layer of synovial fluid was detected in 12 % of probands. The configuration of the capsule varied with different rotation positions of the legs. In small children the mean NCD-A increased from 2.5 mm at 65 cm height to 5 mm at 100 cm height. In larger children the mean NCD-A was 5.5 mm. The mean right-to-left difference was 0.5 mm with a pathological limit of 2 mm.Conclusions. The pathological limit of the NCD-A increases from 3.5 to 7.5 mm in relation to the height. Sonographic investigation of the pediatric hip joint must include detailed demonstration of anatomical structures to avoid misinterpretations.


Femoral Neck Synovial Fluid Section Plane Anterior Surface Sagittal Section 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Terjesen T, Osthus P (1991) Ultrasound in the diagnosis and follow-up of transient synovitis of the hip. J Pediatr Orthop 11: 608–613Google Scholar
  2. 2.
    McGoldrick F, Bourke T, Blake N, Fogarty E, Dowling F, Regan B (1990) Accuracy of sonography in transient synovitis. J Pediatr Orthop 10: 501–503Google Scholar
  3. 3.
    Gopakumar TS, Vaishya R, Klenerman L, Carty H (1992) The role of ultrasound and isotope scanning in the management of irritable hips. Eur J Radiol 15:13–117Google Scholar
  4. 4.
    Wilson DJ, Green DJ, MacLarnon JC (1984) Arthrosonography of the painful hip. Clin Radiol 35: 17–19Google Scholar
  5. 5.
    Dörr U, Zieger M, Hauke H (1988) Ultrasonography of the painful hip. Pediatr Radiol 19: 36–40Google Scholar
  6. 6.
    Zieger M (1990) Sonographie des kindlichen Hüftgelenks. Springer, Berlin New York, pp 16–56, 106–128Google Scholar
  7. 7.
    Schlesinger AE, Hernandez RJ (1992) Diseases of the musculoskeletal system in children: imaging with CT, sonography and MR. AJR 158:729–741Google Scholar
  8. 8.
    Bickerstaff DR, Neal LM, Booth AJ, Brennan PO, Bell MJ (1990) Ultrasound examination of irritable hip. J Bone Joint Surg [Br] 72: 549–553Google Scholar
  9. 9.
    Adam R, Hendry GMA, Moss J, Wild SR, Gillespie I (1986) Arthrosonography of the irritable hip in childhood: a review of one year's experience. Br J Radiol 59: 205–208Google Scholar
  10. 10.
    Egund N, Wingstrand H (1989) Pitfalls in ultrasonography of hip joint synovitis in the child. Acta Radiol 30: 375–378Google Scholar
  11. 11.
    Kallio P, Ryöppy S, Jäppinen S, Siponmaa A-K, Jääskeläinen J, Kunnamo I (1985) Ultrasonography in hip disease in children. Acta Orthop Scand 56: 367–371Google Scholar
  12. 12.
    Marchal GJ, Van Holsbeeck MT, Raes M, et al (1987) Transient synovitis of the hip in children: role of US. Radiology 162:825–828Google Scholar
  13. 13.
    Futami T, Kasahara Y, Suzuki S, Ushikubo S, Tsuchiya T (1991) Ultrasonography in transient synovitis and early Perthes' disease. J Bone Joint Surg [Br] 73:635–639Google Scholar
  14. 14.
    Dörr U, Zieger M (1989) Morbus Perthes: Aussagemöglichkeiten und Stellenwert der Sonographie. Radiologe 29: 182–186Google Scholar
  15. 15.
    Terjesen T (1993) Ultrasonography in the primary evaluation of patients with Perthes' disease. J Pediatr Orthop 13: 437–443Google Scholar
  16. 16.
    Wirth T, LeQuesne GW, Paterson DC (1992) Ultrasonography in Legg-Calvé-Perthes disease. Pediatr Radiol 22: 498–504Google Scholar
  17. 17.
    Naumann T, Kollmannsberger A, Fischer M, Puhl W (1992) Ultrasonographic evaluation of Legg-Calvé-Perthes disease based on sonoanatomic criteria and the application of new measuring techniques. Eur J Radiol 15: 101–106Google Scholar
  18. 18.
    Terjesen T (1992) Ultrasonography for diagnosis of slipped capital femoral epiphysis. Acta Orthop Scand 63: 653–657Google Scholar
  19. 19.
    Castriota-Scanderbeg A, De Micheli V, Orsi E (1994) Letter to the editor: ultrasound and hip joint effusion. Eur J Radiol 18: 74–75Google Scholar
  20. 20.
    Leonardt H, Tillmann B, Töndury G, Zilles K (1987) Rauber, Kopsch, Anatomie des Menschen. vol 1: Bewegungsapparat. Thieme, Stuttgart, pp 498–502Google Scholar
  21. 21.
    Miralles M, Gonzalez G, Pulpeiro JR, et al (1989) Sonography of the painful hip in children: 500 consecutive cases. AJR 152:579–582Google Scholar

Copyright information

© Springer-Verlag 1996

Authors and Affiliations

  • Wiltrud K. Rohrschneider
    • 1
  • Gabriele Fuchs
    • 1
  • Jochen Tröger
    • 1
  1. 1.Universität Heidelberg, Pädiatrische RadiologieHeidelbergGermany

Personalised recommendations