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Developmental Dysplasia of the Hip: Optimal Ultrasound Screening Strategy Among High Risk Newborns

Received: 21 January 2015    Accepted: 11 February 2015    Published: 23 April 2015
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Abstract

Musculoskeletal ultrasonography is becoming an attractive imaging modality for screening of high risk infants for DDH because of its advantages such as accessibility, low cost, rapid examination and ability to detect the soft tissues & cartilage which cannot be seen by conventional radiography. Hip ultrasonography has the ability not only to visualise the unossified parts of the newborn hip but also to show movement of the femoral head within the socket. Ultrsonographic screening of all newborns can identify cases at an earlier age and lead to earlier treatment and prevent complication. So we conclude that the hip ultrasound screening of high risk infants for developmental dysplasia of the hip is important for early diagnosis & treatment. The current study included 270 cases of high risk infants for DDH. Their ages ranged from 4weeks to 6 months. We found that the most prevalent risk factor for hip dislocation in our study was ceaserean section delivery followed by breech presentation and oligohydraminos. The mean value of Alpha angle of the right hip was high than that of the left hip, where mean values of Beta angle of left hip was high than that of right hip. Graf type degree Ia was the most frequent degree in the right & left hips followed by IIa in right hip and IIb in left hip. Caesarean section delivery was the most prevalent risk factor in Graf type degree Ia, IIa & Ib in the right hip and in Graf type degree Ia, IIa & IIb in the left hip. Clinical suspicion was more frequent in Graf type degree IIc. Positive family history & oligohydramnios were the most frequent risk factors in Graf type IIb in the right hip. Graf type Ia was the most frequent degree among both males & females in the studied group in the right and left hips. Among risk factors breech presentation and oligohydramnios were significantly higher in female infants than male infants while caesarean section was significantly higher in male infants than female infants. Normal degree of hip stability is the most frequent degree in the right and left hips by Harche dynamic technique.

Published in International Journal of Medical Imaging (Volume 3, Issue 3)
DOI 10.11648/j.ijmi.20150303.12
Page(s) 49-58
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Musculoskeletal, Ultrasonography, Hip Dislocation

References
[1] Herring JA. Developmental dysplasia of the hip. In Tachdjian's pediatric orthopedics. Edited by Herring JA, W.B. Saunders co. Philadelphia 2002; 513-646.
[2] Wientroub S and Grill F. Ultrasonography in Developmental Dysplasia of the Hip, J. Bone Joint Surg Am.2000; 82:1004.
[3] Karen R, Carol D, Kari R, et al. Immediate Treatment Versus Sonographic Surveillance for Mild Hip Dysplasia in Newborns, j. of Pediatrics. 2010; 125:e9–e16
[4] Storer D. How is hip dysplasia diagnosed? Am Fam Physician.2006; 74 (8):1310-6.
[5] Scott S, Lercher K, Benaroya A, et al. Diagnosis and management of infant hip dysplasia.In: hip ultrasonography edited by Graf R. Second edition, Library of Congress Control Number.2006 p. 6-8.
[6] Tonnis D, Storch K and Ulbrich H. Results of newborn screening of CDH with and without sonography and correlation of risk factors. J. Pediatr Orthop.1990; 10: 145-52.
[7] Paton RW, Hopgood PJ and Eccles K. Instability of the neonatal hip: the role of early or late splintage. International Orthopaedics. 2004; 28, 5: 270-73.
[8] Weinstein S. Developmental hip dysplasia and dislocation. In: pediatric orthopaedics ed. by Morrissy RT, Weinstein SL, Lovell and Winter's. Philadelphia: Lippincott Williams and Wilkins. 2001; chapter 2, p. 905-56.
[9] Jones DA and Powell N. Ultrsound and neonatal hip screening. British editional society of bone and joint surgery.1990; 72-B:457-9
[10] Dante B, Giuseppe A, Francesco A, et al. Screening for developmental dysplasia of the hip. Pediatrics: the official journal of the American Academy. 1997; e5: 99
[11] Roovers EA, Boere-Boonekamp MM, Castelein RM, et al. Effectiveness of ultrasound screening for developmental dysplasia of the hip, Arch Dis Child Fetal Neonatal Ed.2005; 90:f25-f30
[12] Sutton D. Developmental dysplasia of the hip, British Journal of Radiology. 2003; 7:1856
[13] Paton RW, Srinivasan MS, Shah B and Hollis S. Ultrasound screening for hips at risk in developmental dysplasia: is it worth it? J. Bone Joint Surg [Br]. 1999; 81-B: 255-8.
[14] Storer S and Skaggs D. Developmental dysplasia of the hip. Annual Clinical Focus on caring for children and adolescents. ACF;Am Fam Physician. 2006; 74(8):1310-1316.
[15] Walter RS, Donaldson JS, Davis CL, et al. Ultrasound screening of high risk infants. A method to increase early detection of congenital dysplasia of the hip. Am J Dischild. 1992; 146:230–34
[16] Marks DS, Clegg J and Al-Chalabi AN. Routine ultrasound screening for neonatal hip instability. J. Bone and Joint Surg.1994; 76-B(4): 534-38
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  • APA Style

    Mohammed Shawky Abdullah, Ashraf Anas Zytoon. (2015). Developmental Dysplasia of the Hip: Optimal Ultrasound Screening Strategy Among High Risk Newborns. International Journal of Medical Imaging, 3(3), 49-58. https://doi.org/10.11648/j.ijmi.20150303.12

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    ACS Style

    Mohammed Shawky Abdullah; Ashraf Anas Zytoon. Developmental Dysplasia of the Hip: Optimal Ultrasound Screening Strategy Among High Risk Newborns. Int. J. Med. Imaging 2015, 3(3), 49-58. doi: 10.11648/j.ijmi.20150303.12

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    AMA Style

    Mohammed Shawky Abdullah, Ashraf Anas Zytoon. Developmental Dysplasia of the Hip: Optimal Ultrasound Screening Strategy Among High Risk Newborns. Int J Med Imaging. 2015;3(3):49-58. doi: 10.11648/j.ijmi.20150303.12

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  • @article{10.11648/j.ijmi.20150303.12,
      author = {Mohammed Shawky Abdullah and Ashraf Anas Zytoon},
      title = {Developmental Dysplasia of the Hip: Optimal Ultrasound Screening Strategy Among High Risk Newborns},
      journal = {International Journal of Medical Imaging},
      volume = {3},
      number = {3},
      pages = {49-58},
      doi = {10.11648/j.ijmi.20150303.12},
      url = {https://doi.org/10.11648/j.ijmi.20150303.12},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijmi.20150303.12},
      abstract = {Musculoskeletal ultrasonography is becoming an attractive imaging modality for screening of high risk infants for DDH because of its advantages such as accessibility, low cost, rapid examination and ability to detect the soft tissues & cartilage which cannot be seen by conventional radiography. Hip ultrasonography has the ability not only to visualise the unossified parts of the newborn hip but also to show movement of the femoral head within the socket. Ultrsonographic screening of all newborns can identify cases at an earlier age and lead to earlier treatment and prevent complication. So we conclude that the hip ultrasound screening of high risk infants for developmental dysplasia of the hip is important for early diagnosis & treatment. The current study included 270 cases of high risk infants for DDH. Their ages ranged from 4weeks to 6 months. We found that the most prevalent risk factor for hip dislocation in our study was ceaserean section delivery followed by breech presentation and oligohydraminos. The mean value of Alpha angle of the right hip was high than that of the left hip, where mean values of Beta angle of left hip was high than that of right hip. Graf type degree Ia was the most frequent degree in the right & left hips followed by IIa in right hip and IIb in left hip. Caesarean section delivery was the most prevalent risk factor in Graf type degree Ia, IIa & Ib in the right hip and in Graf type degree Ia, IIa & IIb in the left hip. Clinical suspicion was more frequent in Graf type degree IIc. Positive family history & oligohydramnios were the most frequent risk factors in Graf type IIb in the right hip. Graf type Ia was the most frequent degree among both males & females in the studied group in the right and left hips. Among risk factors breech presentation and oligohydramnios were significantly higher in female infants than male infants while caesarean section was significantly higher in male infants than female infants. Normal degree of hip stability is the most frequent degree in the right and left hips by Harche dynamic technique.},
     year = {2015}
    }
    

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  • TY  - JOUR
    T1  - Developmental Dysplasia of the Hip: Optimal Ultrasound Screening Strategy Among High Risk Newborns
    AU  - Mohammed Shawky Abdullah
    AU  - Ashraf Anas Zytoon
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    DO  - 10.11648/j.ijmi.20150303.12
    T2  - International Journal of Medical Imaging
    JF  - International Journal of Medical Imaging
    JO  - International Journal of Medical Imaging
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    AB  - Musculoskeletal ultrasonography is becoming an attractive imaging modality for screening of high risk infants for DDH because of its advantages such as accessibility, low cost, rapid examination and ability to detect the soft tissues & cartilage which cannot be seen by conventional radiography. Hip ultrasonography has the ability not only to visualise the unossified parts of the newborn hip but also to show movement of the femoral head within the socket. Ultrsonographic screening of all newborns can identify cases at an earlier age and lead to earlier treatment and prevent complication. So we conclude that the hip ultrasound screening of high risk infants for developmental dysplasia of the hip is important for early diagnosis & treatment. The current study included 270 cases of high risk infants for DDH. Their ages ranged from 4weeks to 6 months. We found that the most prevalent risk factor for hip dislocation in our study was ceaserean section delivery followed by breech presentation and oligohydraminos. The mean value of Alpha angle of the right hip was high than that of the left hip, where mean values of Beta angle of left hip was high than that of right hip. Graf type degree Ia was the most frequent degree in the right & left hips followed by IIa in right hip and IIb in left hip. Caesarean section delivery was the most prevalent risk factor in Graf type degree Ia, IIa & Ib in the right hip and in Graf type degree Ia, IIa & IIb in the left hip. Clinical suspicion was more frequent in Graf type degree IIc. Positive family history & oligohydramnios were the most frequent risk factors in Graf type IIb in the right hip. Graf type Ia was the most frequent degree among both males & females in the studied group in the right and left hips. Among risk factors breech presentation and oligohydramnios were significantly higher in female infants than male infants while caesarean section was significantly higher in male infants than female infants. Normal degree of hip stability is the most frequent degree in the right and left hips by Harche dynamic technique.
    VL  - 3
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    ER  - 

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Author Information
  • Radiology Department, Faculty of Medicine, Menoufiya University Menoufiya, Egypt

  • Radiology Department, Faculty of Medicine, Menoufiya University Menoufiya, Egypt

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