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Hip Arthrography Complicated by Air Embolism in Infants

A Report of 2 Cases

Bell, Courtney, MD1; Greene, Nattaly, BS1; Kato, Meredith, MD1; Goldstein, Rachel, MD, MPH2; Yang, Scott, MD1

doi: 10.2106/JBJS.CC.18.00083
Case Reports

Case: We report 2 cases of infants with developmental dysplasia of the hip who underwent arthrography of the hip with use of air for structure identification, which resulted in a presumed air embolism and deep oxygen desaturation. This led to the hypothesis that there is an increased potential of air embolism in the pediatric population given the vascular anatomy of the hip.

Conclusion: These 2 cases document the important and not well-known complication of air embolism during air arthrography, which resulted in a change of practice for the authors. We strongly recommend against the use of air as an adjunct to routine arthrography in children.

1Departments of Orthopaedics & Rehabilitation (C.B., N.G., and S.Y.) and Anesthesiology & Perioperative Medicine (M.K.), Oregon Health & Science University, Portland, Oregon

2Children’s Orthopaedic Center, Children’s Hospital Los Angeles, Los Angeles, California

Investigation performed at Oregon Health & Science University, Portland, Oregon, and Children’s Hospital Los Angeles, Los Angeles, California

Disclosure: The authors indicated that no external funding was received for any aspect of this work. The Disclosure of Potential Conflicts of Interest forms are provided with the online version of the article (

Copyright © 2019 by The Journal of Bone and Joint Surgery, Incorporated
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