PMC4638133_01
Plain radiograms of the hips in AP (A) and frog-leg lateral (B) projections. There is a valgus deformity of the hips. Apart from that, the hips are unremarkable.
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AP and axial x-ray examination of the hips revealed normal acetabula of both hip joints with proper covering of femoral heads (Wiberg angle was 35 degrees bilaterally), symmetrical hip joint spaces and valgus hips (femoral neck-shaft angle was 155 degrees on the right side and 161 degrees on the left) (Figure 1).
MRI of the hips. PD-weighted images with fat suppression in the axial plane (A) show bilateral edema of the quadriceps femoris muscles (arrows), the abnormality is more prominent on the left. On T1-weighted axial images (B), there is a subtle fatty atrophy of the quadriceps femoris muscles (arrow). (C) A T1-weighted image in the axial plane showing the technique of IFS measurement (red) and QFS (yellow), as described by Torriani et al.. Both IFS and QFS are markedly reduced.
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Hip MRI was performed for better assessment of soft tissues, revealing bilateral edema and discrete fatty atrophy of quadriceps femoris muscles (Figure 2A, 2B). The distance between lesser trochanter of the femur and ischial bone was 12 mm on the right and 14 mm on the left, while the distance between the lesser trochanter and ischiotibial muscle equaled 13 mm and 14 mm, respectively (Figure 2C).