Developmental Hip Dysplasia and Early Diagnosis with Ultrasonography
DOI:
https://doi.org/10.5281/zenodo.16585205Keywords:
Developmental hip dysplasia, ultrasonography, Ortolani- Barlow testsAbstract
Introduction: The prognosis of children treated for hip dysplasia is excellent, especially when diagnosed early and managed with non-surgical methods. However, when open surgical reduction is required, short-term outcomes may be less favorable. The aim of this study is to investigate the risk factors leading to developmental dysplasia of the hip and to evaluate the diagnostic value of hip ultrasonography in light of current literature.
Materials and Methods: This research was conducted as part of a thesis study at the Radiology Clinic of Istanbul Haydarpaşa Numune Hospital. A total of 246 newborns (170 females and 76 males; 492 hips in total) were included in the study, regardless of whether they had undergone an orthopedic physical examination for routine screening. Evaluations were performed using standard and dynamic ultrasonography (USG) methods. Only cases with high suspicion or those meeting the criteria for a dislocated hip were confirmed by radiography. Therefore, the sensitivity and specificity of ultrasonography compared to radiography could not be determined. The youngest infant included in the study was 1 month old, while the oldest was 9 months old; 169 infants were under 3 months of age, and 77 were over 3 months. Informed consent was obtained from the families, and relevant anamnesis data were recorded. Infants requiring follow-up were scheduled for a control examination after four weeks.
Results: In our study, immature hips were detected in 82 female infants (16.67%) and 20 male infants (4.06%). The frequency of dysplastic hips was found to be 24 cases (4.88%) in female infants and 2 cases (0.41%) in male infants, with statistically significant differences between genders for both immature (p<0.03) and dysplastic (p<0.035) hips. The risk of hip immaturity and dysplasia was higher in infants with a positive Ortolani-Barlow test and at least one or more risk factors.
Conclusion: Our findings suggest that the simultaneous use of ultrasonographic evaluation along with physical examination tests may contribute significantly to the diagnosis.
Downloads
References
Referanslar ;
- P. J. Klisic, MD, PhD, Clinical Professor Ortopedska Bolnica Banjica, J Bone Joint Surg (Br) 1989; 71-B:136 DOI: 10.1302/0301-620X.71B1.2914985
- Baran Sarikaya , Serkan Sipahioglu , Zeynep Bekin Sarikaya , Celal Bozkurt , Ali Levent , Metin Yapti , Mehmet Akif Altay , Ugur Erdem Isikan . Assessment of hip development in the early period in patients who underwent dega osteotomy due to developmental dysplasia of the hip . 2017;(24:2):173-7 https://doi.org/10.5281/zenodo.10018988
- Ilari Kuitunen 1,2,✉, Mikko M Uimonen 3, Marjut Haapanen 1, Reijo Sund 4, Ilkka Helenius 5,6, Ville T Ponkilainen 3Incidence of Neonatal Developmental Dysplasia of the Hip and Late Detection Rates Based on Screening Strategy A Systematic Review and Meta-analysis. JAMA Netw Open . 2022 Aug 18;5(8):e2227638. doi: 10.1001/jamanetworkopen.2022.27638
- LE Grissom, HT Harcke, Ultrasonography and developmental dysplasia of the infant hip Current Opinion in Orthopaedics April 2000 - Volume 11 - Issue 2 - pp 127-130
- Copuroglu C, Ozcan M, Aykac B, Tuncer B, Saridogan K. Reliability of ultrasonographic measurements in suspected patients of developmental dysplasia of the hip and correlation with the acetabular index. Indian journal of orthopaedics. 2011;45(6):553-7
- Graf R (1984) Classification of hip joint dysplasia by means of sonography. Arch Orthop Trauma Surg 102:248–255
- Harcke HT, Grisom LE (1990) Performing dynamic sonography of the infant hip. Am J Roentgenol 155:837–844
- Harcke HT, Clarke NMP, Lee MS, Borns PF, MacEwen GD (1984) Examination of the infant hip with real-time ultrasonography. J Ultrasound Med 3:131–137
- Suzuki S, Kasahara Y, Futami T, Ushikubo S, Tsuchiya T (1991) Ultrasonography in congenital dislocation of the hip. Simultaneous imaging of both hips from in front. J Bone Joint Surg Br 73:879–883
- Terjesen T, Bredland T, Berg V (1989) Ultrasound for hip assessment in the newborn. J Bone Joint Surg Br 71:767–773
- Terjesen T, Runde´n TO, Tangerud A (1989) Ultrasonography and radiography of the hip in infants. Acta Orthop Scand 60:651–660
- Terjesen T, Runde´n TO, Johnsen HM (1991) Ultrasound in the diagnosis of congenital dysplasia and dislocation of the hip joints in children older than two years. Clin Orthop Relat Res 262:159–169
- Sewell MD, Rosendahl K, Eastwood DM (2009) Developmental dysplasia of the hip. BMJ 339:b4454
- Holen KJ, Tegnander A, Bredland T, Johansen OJ, Saether OD, Eik-Nes SH, Terjesen T (2002) Universal or selective screening of the neonatal hip using ultrasound? A prospective, randomised trial of 15,529 newborn infants. J Bone Joint Surg Br 84:886–890
- Rosendahl K, Markestad T, Lie RT (1994) Ultrasound screening for developmental dysplasia of the hip in the neonate: the effect on treatment rate and prevalence of late cases. Pediatrics 94:47–52
- Aborie LB, Engesæter IØ, Lehmann TG, Eastwood DM, Engesæter LB, Rosendahl K (2013) Screening strategies for hip dysplasia: long-term outcome of a randomized controlled trial. Pediatrics 132:492–501
- Omeroglu H, Koparal S (2001) The role of clinical examination and risk factors in the diagnosis of developmental dysplasia of the hip: a prospective study in 188 referred young infants. Arch Orthop Trauma Surg 121:7–11
- Engesæter IØ, Lehmann T, Laborie LB, Lie SA, Rosendahl K, Engesæter LB (2011) Total hip replacement in young adults with hip dysplasia: age at diagnosis, previous treatment, quality of life, and validation of diagnoses reported to the Norwegian Arthroplasty Register between 1987 and 2007. Acta Orthop 82:149–154
- Mahan ST, Katz JN, Kim YJ (2009) To screen or not to screen? A decision analysis of the utility of screening for developmental dysplasia of the hip. J Bone Joint Surg Am 91:1705–1719
- Tümer Y, Ömeroğlu H. Prevention of developmental hip dysplasia in Turkey. Acta Orthop Traumatol Turc 1997;31:176-81.
- Doğruel H, Atalar H, Yavuz OY, Uraş İ, Günay C, Şaylı U. An Evaluation of Developmental Hip Dysplasia Frequency and Screening Programs in Turkey: Review Turkiye Klinikleri J Med Sci 2008;28:357-60
- Söyüncü Y, Özdemir H, Akyıldız FF, Ürgüden M, Altınel E. Searching of developmental dysplasia of hip in Antalya and surrounding. Acta Orthop Traumatol Turc 1999;33:105-9.
- Bialik V, Bialik GM, Blazer S, Sujov P, Wiener F, Berant M (1999) Developmental dysplasia of the hip: a new approach to incidence. Pediatrics 103:93–99
- Roovers EA, Boere-Boonekamp MM, Mostert AK, Castelein RM, Zielhuis GA, Kerkhoff THM (2005) The natural history of developmental dysplasia of the hip: sonographic findings in infants of 1–3 months of age. J Pediatr Orthop B 14:325–330
- Farr S, Grill F, Mu¨ller D (2008) When is the optimal time for hip ultrasound screening? Orthopade 37:532–540
- Bache CE, Clegg J, Herron M. Risk factors for developmental dysplasia of the hip: ultrasonographic findings in the neonatal period. J Pediatr Orthop B 2002;11:212-8.
- önnis D, Storch K, Ulbrich H. Results of newborn screening for CDH with and without sonography and correlation of risk factors. J Pediatr Orthop 1990;10:145–52.
- Çakır Çuhacı B, Kibar AE, Çakır HT, Arhan E, Cansu A, Yakut Hİ. Ultrasonographic examination of developmental dysplasia of the hip in 300 infants. Turkish J Pediatr Dis 2009;3:5-9.
- Chan A, McCaul KA, Cundy PJ, Haan EA, Byron-Scott R. Perinatal risk factors for developmental dysplasia of the hip. Arch Dis Child 1997;76:94–100.
- de Hundt M, Vlemmix F, Bais JMJ, et al. Risk factors for developmental dysplasia of the hip: a meta-analysis. Eur J Obstet Gynecol Reprod 2012;165:8-17.
- Rosenberg N, Bialik V, Norman D, Blazer S. The importance of combined clinical and sonographic examination of instability of the neonatal hip. Int Orthop 1998;22:185–8.
- Lowry CA, Donoghue VB, Murphy JF. Auditing hip ultrasound screening of infants at increased risk of developmental dysplasia of the hip. Arch Dis Child 2005;90:579-81.
- Harcke HT, Kumar SJ. The role of ultrasound in the diagnosis and management of congenital dislocation and dysplasia of the hip. J Bone Joint Surg Am 1991;73:622–8.
- Barlow T. Early diagnosis and treatment of congenital dislocation of the hip. J Bone Joint Surg 1962;44-B:292-301.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 Melike söğütlügil
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
