Canine Hip Luxation Diagnosis: Ultrasound vs Radiographs

VRU 63(6): 779-789

June 29, 2023

  • Background: Acute hip luxation is a common musculoskeletal injury in dogs. Radiographs are the preferred imaging modality for confirming the diagnosis. In large animal and human medicine, ultrasound is often utilized for this purpose.

  • Study: The objectives of this three-part study were to utilize a canine cadaver model to establish ultrasonographic features of hip luxation and evaluate the accuracy and reliability for diagnosing hip luxation with ultrasound.

  • Method: A cadaver model was developed that allowed manual luxation and subsequent ultrasonography of the hip joint while in four directions of luxation. A description of the ultrasonographic features for each direction of luxation was created. 16 residency-trained and intern veterinarians without prior experience in this technique performed randomized, repeated ultrasound exams on cadaver hips assigned as normal or luxated.

  • Results: A total of 1140 hip ultrasounds were performed with good accuracy (median, 90.8%; range, 61.4–100%), sensitivity (89.5%), and specificity (80.0%) for diagnosing the presence of hip luxation. Accuracy for identifying the correct quadrant of luxation was significantly lower (mean, 58.6%; range, 24.6–90.8%; P < 0.001). Intraobserver accuracy agreement varied widely from none to almost perfect agreement, and interobserver agreement ranged from slight to moderate agreement.

  • Conclusions: The results of this study supported the use of ultrasound for diagnosing the presence of hip luxation but did not support replacing radiographs for diagnosing the direction of luxation.

A-E. Graphic illustration of probe placement and corresponding ultrasound images of a normal hip (medial-lateral probe orientation): A and B, cranial aspect (wing) of ilium (1); C and D, caudal aspect (body) of ilium (2); E and F, acetabulum (3) with femoral head (4), femoral neck (5), and greater trochanter (6); G and H, ischium (7); I and J, tuber ischium (8); K and L, distal-proximal probe orientation on the lateral aspect of the greater trochanter


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