Use of Ultrasonography in Developmental Dysplasia of the Hip. Developmental Dysplasia of the Hip: Quality of Reporting of Diagnostic Accuracy for US. The Diagnosis of Congenital Hip-Joint Dislocation by the Ultrasonic Combound Treatment.

Screening for Developmental Dysplasia of the Hip: Recommendation Statement. Open reduction (ORIF): much older patients or if closed reduction is not successful 10 Pavlik harness: usually for younger patients (less than 6 months of age)Ĭlosed reduction: usually for older patients after 1 year of age The acetabular angle should be 5 years of age. Interruption of the Shenton line may also be evident. The femoral head should be centered in the inferomedial quadrant defined by the intersection of Hilgenreiner line and Perkin line. Determine the relationship of the proximal femur to the developing pelvis. A frog-leg lateral view does not add additional information but does double the radiation dose 15.Īsymmetry of the femoral head ossification center (delayed on the abnormal side) is often present. Plain radiographĪ single AP radiograph is the most appropriate examination in children where femoral head ossification has occurred, e.g. Ultrasound is the test of choice in the infant (50% is considered normal 7,14. One-third of cases are affected bilaterally 5. Once there is a significant ossification then an x-ray examination is required.įor some reason, the left hip is said to be more frequently affected 4. Radiographic featuresįor imaging assessment of developmental dysplasia of the hip, ultrasound is the modality of choice prior to the ossification of the proximal femoral epiphysis.

In addition, there is very cellular hyaline cartilage allowing the femoral head to glide out of the acetabulum generating the palpable clunk known as the Ortolani sign 12,13. In general, the dysplastic hip has a ridge ( neolimbus) in the superolateral region of the acetabulum composed of hypertrophied fibrocartilage as a result of the abnormal joint congruity 13. The diagnosis is then usually confirmed with ultrasound, although the role of ultrasound in screening is controversial 1,3. Risk factorsĭevelopmental dysplasia of the hip is usually suspected in the early neonatal period due to the widespread adoption of clinical examination (including the Ortolani test, Barlow maneuvers, and Galeazzi sign). The reported incidence of developmental dysplasia of the hip varies between 1.5- births 1, with the majority (60-80%) of abnormal hips resolving spontaneously within 2-8 weeks 1 (so-called immature hip).

Hip dysplacia xray shoing normal