Ultrasound screening for developmental dysplasia of the hip: indications, method and illustrative cases

Congress:

ESSR 2019

Poster Number:

P-0168

Type:

Educational Poster

Keywords:

Developmental disease, Education, Ultrasound, Musculoskeletal system, Musculoskeletal joint

Authors:

A. R. Ventosa¹, P. M. G. Alves², A. S. Linhares Moreira², H. Patricio²; ¹Portimão/PT, ²Faro/PT

DOI:

10.26044/essr2019/P-0168

DOI-Link:

https://dx.doi.org/10.26044/essr2019/P-0168

Fig. 1: Standard coronal plane of the infant hip – anatomical structures.

Fig. 2: Coronal ultrasound image depicting how to measure alpha and beta angles.

Fig. 3: Infant hip types according to Graf’s classification.

Fig. 7: Dysplastic hip in a 3-month-old infant – Graf type IIb (alpha-angle 50-59º)....

Fig. 9: Decentered hip in a 5-week-old girl – Graf type D hip (alpha-angle 43-49º;...

Fig. 11: Eccentric hip - Graf type IV hip. Labrum - yellow arrow - is inverted and...

Learning objectives

To review the indications to perform an ultrasound screening for developmental dysplasia of the hip. To review the basic technique of hip ultrasound used in this setting and its interpretation. To illustrate the normal anatomy and the range of pathologic findings in the developmental dysplasia of the hip.

Background

Developmental dysplasia of the hip (DDH) comprises a broad spectrum of pathologies which have in common changes in the normal hip joint congruity. Usually, both ligamentous laxity and bone structural factors such as acetabular dysplasia are implied. The precise etiology of DDH is not defined, although several risk factors are recognized. In the first months of life, the cartilaginous component of the hip joint predominates. Ultrasonography allows a direct visualization of cartilage and, thus, the morphologic evaluation of this joint early in life, being considered...

Imaging findings OR Procedure Details

Indications to perform an ultrasound evaluation for DDH: Abnormal findings on physical examination of the hip; Newborns/infants with a normal physical examination of the hip but having risk factors for DDH. Risk factors for DDH: Family history of DDH; Breech birth; Postural molding conditions (torticollis, skull or foot deformities); Primiparity; Macrosomia; Oligohydramnios; Female sex. In the screening setting, the ultrasound evaluation for DDH must be performed between 4 and 6 weeks of life. Technique Ultrasound evaluation of the hip is performed with a linear transducer...

Conclusion

Early diagnosis of developmental dysplasia of the hip is essential for providing an effective treatment, preventing morbidity in the long-term. For this purpose, ultrasound is a reliable and safe method, provided that the performing radiologist is familiar with the technique, the normal anatomy and the pathologic findings.

References

Servaes S. “Developmental dysplasia of the hip.” Caffey’s Pediatric Diagnostic Imaging. 13th edition. Coley BD. Philadelphia: Elsevier, 2019. 1316-1322. Graf R. Hip sonography - diagnosis and management of infant hip dysplasia. 2nd edition. Berlin Heidelberg: Springer-Verlag, 2006. Chlapoutakis K, Kolovos S, Casini C. Ultrasonography in developmental dysplasia of the hip: A review of current clinical strategies and recommendations for revision of practice. Hell J Radiol 2017; 2(3): 36-46. Couture A, Baud C, Prodhomme O et al. Échographie de la hanche néonatale: bilan initial et suivi...

Personal Information

Ana Rita Ventosa Pedro Alves Ana Sofia Moreira Henrique Patrício Department of Radiology Centro Hospitalar e Universitário do Algarve Portugal