PMC6431357_01
Plain AP radiograph performed in April 2014 shows dislocation of the left hip and pseudoacetabulum.
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fig1
Imaging demonstrated bilateral hip dysplasia with left hip dislocation with pseudoacetabuli (Figures 1 and 2).
Coronal cuts of CT scan shows bilateral acetabular dysplasia with dislocated left femoral head localized in the anterosuperior aspect of the acetabulum with development of pseudoacetabulum.
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fig2
Imaging demonstrated bilateral hip dysplasia with left hip dislocation with pseudoacetabuli (Figures 1 and 2).
Plain AP radiograph performed on admission shows bony destruction of the bilateral acetabula and rapid progression of the left proximal femur with early cortical erosion of the right femoral head.
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fig3
Imaging demonstrated erosive changes of the bilateral femoral heads with infiltrative destructive patterns to the bilateral acetabula, hip effusions, and synovial thickening (Figures 3 and 4).
MRI pelvis with coronal T1 (a) and coronal STIR (b) of pelvis performed on admission shows bilateral dislocated hips with right greater than left joint effusions, synovial thickening, and rice body formation.
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fig4
Imaging demonstrated erosive changes of the bilateral femoral heads with infiltrative destructive patterns to the bilateral acetabula, hip effusions, and synovial thickening (Figures 3 and 4).
Left hip arthroscopic imaging shows (a) intact labrum with destruction of the acetabulum, (b) destroyed joint capsule, (c) cartilaginous destruction of the femoral head and acetabulum, and (d) loose bodies removed from the left hip.
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On the left, there was a free-floating femoral head with multiple moderate-sized osteochondral loose bodies grossly inflamed synovium, intact labrum, no clearly discernable joint capsule, and near-complete absence of cartilage within the acetabulum and overlying the femoral head (Figure 5).
Plain AP radiograph performed 6 weeks after surgery shows interval resection of the femoral head that was fragmented. There is also resection of bony fragmentation adjacent to the acetabulum.
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Postoperative X-rays showed left femoral head resection (Figure 6).
Plain AP radiograph performed one year after arthroscopic removal of femoral heads shows interval erosion of the right femoral head.
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At 3-year postoperatively, she has continued erosion of the right femoral head (Figure 7).