Hip arthrography in the assessment of children with developmental dysplasia of the hip and Perthes' disease.

In our unit, children with developmental dysplasia of the hip or Perthes' disease, for whom an operation is considered, undergo examination under anaesthetic and a hip arthrogram. This prospective study assessed whether the arthrogram modified treatment and analysed the reliability of its interpretation. All children undergoing a hip arthrogram for developmental dysplasia of the hip and Perthes' disease over a 12-month period were included. Treatment plans before and after the arthrogram were compared for each of the three children's consultants. The preoperative and arthrographic appearances were blindly reviewed to monitor reproducibility. Twenty-one patients with developmental dysplasia of the hip and 19 with Perthes' disease were included. The treatment plan was modified in 12 of the 21 (57.1%) patients with developmental dysplasia of the hip as a consequence of the arthrogram and six of the 19 patients (31.6%) with Perthes' disease. Intraobserver consultant agreement was high but interobserver agreement was only moderate. Static and dynamic arthrography helps decision-making in patients with developmental dysplasia of the hip and Perthes' disease.