Treatment of dislocation of the hip, detected in early childhood, based on magnetic resonance imaging.

In seven children in whom congenital dislocation of the hip was diagnosed after they began to walk, magnetic resonance imaging provided important information for treatment. In five children, it revealed adhesion of the capsule to the ilium, an inverted limbus, and a displaced transverse ligament; these findings indicated a need for open reduction. In the other two children, magnetic resonance imaging demonstrated that the capsule was redundant and appeared to have been stripped from the posterosuperior part of the acetabular rim; this allowed closed reduction. Repeat magnetic-resonance imaging in these two hips suggested that the capsule gradually shrank after several months. The findings in these two patients suggested a long-standing Grade-I congenital dislocation of the hip, as described by Dunn and by Ogden. Children who have this type of congenital dislocation can be treated with closed reduction, provided there is prolonged immobilization of the hip.