Waldenström sign (hip)

Last revised by Dr Henry Knipe on 24 Jun 2018

Waldenström sign is the increased distance between the pelvic teardrop and the femoral head. It is a highly specific sign of a hip joint effusion.

Radiographic features

Plain radiograph
  • >11 mm total distance or >2 mm difference compared to contralateral hip 1,2
  • measured between the lateral aspect of the pelvic teardrop and the medial aspect of the femoral head (referred to as Kohler teardrop distance) 1,2

History and etymology

It is named after the Swedish orthopedic surgeon, J (Johann) Henning Waldenström (1877-1972) 4, who published the first description of the sign in an article on Legg-Calvé-Perthes disease in children in 1934 3Waldenström macroglobulinemia is named after Jan Gösta Waldenström, who was the son of Henning Waldenström. 

The sign was only first confirmed to represent a hip effusion in adults in 1987 5.

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