Comparison Static and Dynamic Ultrasound Techniques of DDH: The Role of the Patient's Position

Document Type : RESEARCH PAPER


1 Department of radiology, faculty medicine, Mashhad University of medical science, Iran

2 Department of Pediatric Orthopedic Surgery, Mashhad University of Medical Science, Iran

3 Department of Radiology, faculty medicine, Arak University of Medical Sciences, Arak, Iran



Objectives: The ultrasound examination of the hip joint is performed in the static (Graf) technique in the 
lateral recumbent position and in the dynamic technique in the supine position. This study compares 
the two static and dynamic techniques and assesses the role of the patient's position in the examination 
of DDH.
Methods: This cross-sectional study was conducted in 2020-2021 at Akbar Hospital, Mashhad University of Medical 
Sciences, Iran. 126 patients suspected of having DDH (199 hip) infants were enrolled in the study. All ultrasound 
examinations were performed with two static and dynamic techniques by a pediatric radiologist.
Results: In the static and dynamic ultrasound examinations, the average alpha angle was 51.57 ± 6.41 degrees, 
and 53.41 ± 6.94 degrees, respectively. These changes were not statistically significant (P = 0.312). The relationship 
and agreement between instability with dynamic technique and instability with static technique (IIC unstable, D, III, 
and IV) were investigated. Significant agreement (Kappa=0.77 (95% CI: 0.66-0.87) with excellent clinical 
significance was obtained between the two ultrasound examination method. Also, in terms of DDH types in the static 
method with instability types in the dynamic method, a substantial agreement was found between the two 
examination methods (Kappa =0.67; (95% CI: 0.59-0.75) with good clinical significance.
Conclusion: In the ultrasound examination of DDH with static and dynamic techniques, the change in the alpha 
angle was not statistically significant. Therefore, the hand of the radiologist is open in measuring alpha angles and 
there is no need to emphasize a specific position. The type of DDH in the static technique completely corresponded 
to the type of stability or instability in the dynamic technique.
 Level of evidence: IV


Main Subjects

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