1. Case of the Week 92 30 year old woman with 1 year of left hip and groin pain. 30 year old woman with 1 year of left hip and groin pain. Over the last two months, the pain intensity has increased with numbness, tingling and weakness of the left leg. Over the last two months, the pain intensity has increased with numbness, tingling and weakness of the left leg. Courtesy of Dr. J. deGraauw, and Dr. Bill Hsu, Canada

2. What are the abnormal findings? What is the Diagnosis? (Spot views next slide) L

3. AP and frog leg left hip

4. Answers Findings Findings Shallow left acetabulum with sclerosis. Shallow left acetabulum with sclerosis. Diagnosis Diagnosis Acetabular dysplasia with mild degenerative joint disease. Acetabular dysplasia with mild degenerative joint disease. L

5. Acetabular depth (7-18mm) Abnormal if < 7mm

6. Center-edge angle (20º–40º) Abnormal if < 20º

7. Acetabular Dysplasia Consequence of incomplete bony modeling leaving a shallow, flattened socket Consequence of incomplete bony modeling leaving a shallow, flattened socket A variant of developmental dysplasia of the hip (DDH) A variant of developmental dysplasia of the hip (DDH) Risk factors Risk factors Female Female Breech presentation Breech presentation First degree relative with DDH First degree relative with DDH Oligohydramnios, talipes, torticollis, birth weight >4kg. Oligohydramnios, talipes, torticollis, birth weight >4kg.

8. SAAD syndrome Symptomatic Adult Acetabular Dysplasia Symptomatic Adult Acetabular Dysplasia Cross sectional analysis of a prospective cohort Cross sectional analysis of a prospective cohort prevalence of adult acetabular dysplasia with hip pain was high (32%) prevalence of adult acetabular dysplasia with hip pain was high (32%) References: F Birrell et. al, Syndrome of symptomatic adult acetabular dysplasia (SAAD syndrome); Annals of the Rheumatic Diseases 2003;62:356 S. Jacobsen and S. Sonne-Holm. Hip dysplasia: a significant risk factor for the development of hip osteoarthritis. A cross-sectional survey; Rheumatology, February 1, 2005; 44(2) 211 - 218.