When investigating someone with a hip disorder, Dr Balakumar aims to ascertain where the pathology is originating from. After thorough history and examination, Dr Balakumar will then utilize imaging to confirm his diagnosis.
Especially if your clinician is considering surgery, then he or she should have convincing imaging suggestive of the pathology. The imaging usually tells the “truth” however it can often be misread or misinterpreted by clinicians. Dr Balakumar would often order a 4 plain X-rays. A standing X-ray pelvis(AP-frontal plane), A standing faux profile (side view of the socket), a Von Rosen view (for hip dysplasia) and a frog lateral view (a side view of the head).
Following this he may supplement this with a CT scan which better delineates and reconstructs bony imaging. Both CT scans and X-rays involves the use of a X-ray beam. The dosage of radiation is similar to a plane trip to Sydney with single X-ray and up to 20x more radiation for CT scans of the hip and pelvis. In itself it is not significant but in repeated doses can be harmful.
Finally Dr Balakumar will often supplement his investigations with cartilage mapping sequences. This is usually designed to give quantitative analysis of the cartilage in the hip to see if the patient is a suitable candidate for joint preservation options. This can be particularly useful when investigating hip dysplasia in the adolescent or adult, where one cannot decide whether joint preservation or joint replacement is the reasonable option. The dGEMRIC (a specialised cartilage mapping sequence) can help not only Dr Balakumar but also the patient.
Dr Balakumar together with radiologists at the Royal Children’s Hospital and Melbourne Radiology Clinic are using this cutting edge technology for this specific patient population. An example of this is below.
This logarithmic curve can give Dr Balakumar and the patient a prognostic % to the chances of success from the joint preservation options such as periacetabular osteotomy. Most of this work was pioneered in the United States and Switzerland and has recently been bought over to Melbourne.
For clinicians interested in this area, below is the link to the article than can be viewed for a evidence based approach to cartilage mapping. The images used in this document have been borrowed from this article.
64 Chapman Street
North Melbourne VIC 3051
Ph: (03) 9329 5525
Fax: (03) 9329 4969
Melbourne Orthopaedic Group
33 The Avenue
Windsor VIC 3181
Ph: (03) 9573 9659
Fax: (03) 9521 2037
Home | Hip Surgery | Patient Information | Contact Us | Search This Site
© 2012-2014 Jit Balakumar - Paediatric & Adult Orthopaedic Surgeon, Melbourne
This is the Popup Module feature. Assign any module to the popup module position, and ensure that the Popup Feature is enabled in the Gantry Administrator.
You can configure its height and width from the Gantry Administrator.