Is ultrasound helpful in the screening of patients at high risk for developmental dysplasia of the hip? A prevalence study on patients with negative Ortolani’s test

Congress:

ECR 2019

Poster Number:

C-1579

Type:

Scientific Exhibit

Keywords:

Dysplasias, Developmental disease, Screening, Diagnostic procedure, Ultrasound, Paediatric, Musculoskeletal joint

Authors:

F. Bondini¹, E. Zanelli², G. Como¹, I. Mauro¹, L. Cattarossi¹, R. Girometti¹, C. Zuiani¹; ¹Udine/IT, ²Udine, italia/IT

DOI:

10.26044/ecr2019/C-1579

DOI-Link:

https://dx.doi.org/10.26044/ecr2019/C-1579

Table 1: Ultrasonographic hip types according to the Graf method.

Fig. 1: Anatomic plane of the hip according to Graf’s classification, with iliac bone...

Methods and materials

US technique:

The study was performed and evaluated by a radiologist and a neonatologist, who used two ultrasound machines (GE Logiq E9 XD and Hitachi Healthcare’s Prosound Alpha 7) and linear highest-frequency transducers (> 7.5 MHz), which were used freehand. A specific pillow was used to maintain newborns in lateral decubitus position, with the hips flexed from 30° to 45º.

Classification:

We used Graf’s method for ultrasound measures and for typization of hips [Table 1]. In particular, we obtained anatomic plane and evaluated the centering of femoral head, bony roof, cartilage roof, with respective alpha and beta angles, and bony rim [Fig 1].

Study population:

We retrospectively reviewed hip US examinations of 578 patients (pz.), performed between August 2016 and February 2018 within an institutional screening program including newborns at risk for DDH. In our study, risk factors considered were: breech presentation, familiarity for DDH, large to born, twins, asymmetry of the skin folds, click of the hip, joint stiffness or laxity and congenital lower limb abnormalities. Among these, 73 infants (12.6%) presented DDH, subsequently divided into two subgroups, i.e. those with pOT (control group), and those with nOT (target group). We calculated the prevalence of DDH and compared it between the two subgroups, then we used Fisher’s exact test for statistic evaluation.