Learning objectives
- Review the important role of ultrasound in the diagnosis or follow-up of development dysplasia of the hip (DDH).
- To illustrate the different methods of ultrasound evaluation in DDH: Graf's,
Harcke's and Morin's.
- Demonstrate the various imaging findings of DDH,
its degrees and their impact in selecting the appropriate treatment.
Background
Development dysplasia of the hip (DDH) is a condition caused by abnormal development and morphology of the acetabulum and by increased ligamentous laxity around the hip,
including a wide spectrum of abnormalities affecting the proximal femur and acetabulum (that range from instability,
dysplasia,
variable degrees of subluxation to an established dislocation).
DDH is a very frequent condition,
being the most frequent congenital musculoskeletal pathology,
with an estimated incidence of 2-20:1000.
DDH occurs more frequently in healthy individuals,
but there is a higher prevalence in some...
Imaging findings OR Procedure Details
From the archive of our institution,
we selected several ultrasound images illustrating the different imaging findings of DDH.
The ultrasound technique is reviewed.
There are three different techniques that can be used for sonographic evaluation of the hip:
- Two of them are based on morphological criteria,
the static techniques of Graf and Morin,
and the other is based on a dynamic evaluation,
Harcke's dynamic technique.
- The hip joints should be evaluated with a linear,
high frequency probe,
with frequencies between 5 MHz and...
Conclusion
Ultrasonography is the first-line imaging technique to evaluate the anatomy,
morphology and stability of the hip and to establish a diagnosis of DDH up to 6 months of age.
By making possible the evaluation of the cartilaginous portions of the hip that may not have expression in radiography,
ultrasound allows an earlier diagnosis of DDH.
Consequently,
the early choice of the most appropriate treatment method will improve the prognosis of these patients by avoiding complications.
Ultrasound offers good sensibility and specificity for the diagnosis of...
References
- BLICKMAN,
Johan et al.
Pediatric Radiology – The Requisites. 3 ed.
Mosby Elsevier.
2009.
- DONNELLY,
Lane.
Fundamentals of Pediatric Imaging. 2 ed.
Elsevier.
2009.
- Ivanoski,
S..
Ultrasound and radiography findings in developmental dysplasia of the hip: a pictorial review. European Congress of Radiology.
C-2542.
2012.
- Lopes P.
et al.
Ultrasound in developmental dislocation and dysplasia of the hip. European Congress of Radiology.
C-0628.
2011.
- Martin A.,
Petruneac D..
Developmental dysplasia of the hip (DDH) – review of major imaging techniques....