EuroSafe Imaging 2020
Performed at one institution, Cross-sectional study, Not applicable, Education and training, Dysplasias, Developmental disease, Technical aspects, Safety, Diagnostic procedure, Digital radiography, Conventional radiography, Radioprotection / Radiation dose, Paediatric, Musculoskeletal joint
E. Zogaj, S. Butorac, N. Kallashi, E. Sina, I. Tabaku, I. Lumi, X. Xhetani, A. Mustafa, V. Demko
Development dysplasia of hip (DDH) is a multifactorial pathology that includes abnormalities of hip joint. Its important to detect DHD early due to the fact that is clinically silent. Treating this pathology early and properly leads to a positive clinical outcome.
DDH is usually suspected in the early neonatal period using physical examination including the Ortolani test, Barlow maneuvers, and Galeazzi sign in 72 hour of being born. After that it proceeds with ultrasound and pelvis x-ray to confirm the diagnosis. 
- physical examinations is performed by pediatrician or pediatric Orthopedic ( better to be performed 2-4 days after newborn is delivered). It‘s the most important, irreplaceable examination regarding DHD.
- US uses a high frequency linear array transducer. Its performed after birth and not only. It has also a high sensitivity to acetabular immaturity and hip laxity that can lead to a possible pathology.
- X-ray has a higher sensibility regarding DHD after 4 months when the ossify nucleus of the femoral head usually appears. It must be used as screening methods only when we have a high suspicion for DDH based on physical examinations and patient history.
The key to plain film assessment of developmental dysplasia of the hip is looking for symmetry and defining the relationship of the proximal femur to the developing pelvis. The ossification of the superior femoral epiphyses should be symmetric. Delay of ossification is a sign of developmental dysplasia of the hip. 
Considering the fact that pelvis x-ray uses radiation, the use of protection during the examination is mandatory.
In our study we want to emphasize the role of X-ray examination and scrutiny for X-ray findings in the diagnosis and follow-up of late-onset development dysplasia of the hips (DDH), using appropriate radiation-protection.
We evaluated the correlation of DDH with the following risk factors: improper swaddling, family history, birth order, gender, delivery-related-complications, as possible indications in patient referral for x-ray examination in our age-group, besides physical findings, considering the most recent guidelines of AAOS(American Academy of Orthopedic Surgeons) and ACR(American College of Radiology).