Clinical History, Examination and Blood Test Results

  • This lady had an unexplained leg length discrepancy

  • A long leg radiograph was obtained however it was hard to find the exact location of the discrepancy

  • EOS scanning was used to get an accurate measurement of the leg length, taking into account pelvic tilt, to assess the cause of the problem

  • EOS imaging takes a simultaneous low dose AP and lateral radiographs with the patient in a functional position. 3D measurements can then be taken from the image which take into account pelvic tilt, posture and flexion in the hip, knee and ankle


Imaging results

EOS SCAN

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LONG LEG RADIOGRAPH

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The measurements taken from the EOS scan calculate the absolute leg length discrepancy taking into account for the pelvic tilt of the patient while they are standing in a functional position. This is not possible with a long leg radiograph. The red boxes highlight the length discrepancies; the L tibia is 2mm longer than the R tibia; the L femur is 9mm longer than the R femur. The red lines highlight buttock crease, showing the functional discrepancy. Overall there is an LLD of 11mm

A long leg radiograph demonstrates a longer left femur, however it is hard to accurately quantify the increase in length from this image


Learning Points

  • EOS imaging allows for a functional leg length discrepancy to be calculated. This can then assist in the surgical planning of correcting this discrepancy.