Assessment of Diagnostic Value of Single View Dynamic Technique in Diagnosis of Developmental Dysplasia of Hip: A Comparison with Static and Dynamic Ultrasond Techniques

Document Type : RESEARCH PAPER

Authors

1 Surgical Oncology Research Center, Faculty of Medicine, Imam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran Department of Radiology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

2 Department of Radiology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

3 Orthopedic Research Center, Mashhad University of Medical Sciences, Mashhad, Iran

Abstract

 
 
 
Background: Developmental dysplasia of hip (DDH) is a common childhood disorder, and ultrasonography examination is routinely used for screening purposes. In this study, we aimed to evaluate a modified combined static and dynamic
 
ultrasound technique for the detection of DDH and to compare with the results of static and dynamic ultrasound techniques.
 
 
 
Methods:
In this cross-sectional study, during 2013- 2015, 300 high-risk infants were evaluated by ultrasound for DDH. Both hips were examined with three techniques: static, dynamic and single view static and dynamic technique. Statistical analysis was performed using SPSS version 11.5.
Results:
Patients aged 9 days to 83 weeks. 75% of the patients were 1 to 3 months old. Among 600 hip joints, about 5% were immature in static sonography and almost all of them were unstable in dynamic techniques. 0.3% of morphologically normal hips were unstable in dynamic sonography and 9% of unstable hips had normal morphology. The mean β angle differences in coronal view before and after stress maneuver was 14.43±5.47° in unstable hips. Single view static and dynamic technique revealed that all cases with acetabular dysplasia, instability and dislocation, except two dislocations, were detected by dynamic transverse view. For two cases, Ortolani maneuver showed femoral head reversibility in dislocated hips. Using single view static and dynamic technique was indicative and applicable for detection of more than 99% of cases.
Conclusion:
Single view static and dynamic technique not only is a fast and easy technique, but also it is of high diagnostic value in assessment of DDH.

Keywords

Main Subjects

References

1. Rosendahl K, Toma P. Ultrasound in the diagnosis of
developmental dysplasia of the hip in newborns. The
European approach. A review of methods, accuracy
and clinical validity. Eur Radiol. 2007; 17(8):1960-7.
2. Lehmann HP, Hinton R, Developmental dysplasia of the
hip practice guideline: technical report. Committee
on Quality Improvement, and Subcommittee on
Developmental Dysplasia of the HipDevelopmental
dysplasia of the hip practice guideline: technical
report. Pediatrics. 2000; 105(4):E57.
3. Boeree NR, Clarke NM. Ultrasound imaging and
secondary screening for congenital dislocation of the
hip. J Bone Joint Surg Br. 1994; 76(4):525-33.
4. Harcke HT. Screening newborns for developmental
dysplasia of the hip: the role of sonography. AJR Am J
Roentgenol. 1994; 162(2):395-7.
5. Morin C, Harcke HT, MacEwen GD. The infant hip:
real-time US assessment of acetabular development.
Radiology. 1985; 157(3):673-7.
6. Keller MS, Weltin GG, Rattner Z, Taylor KJ, Rosenfield
NS. Normal instability of the hip in the neonate: US
standards. Radiology. 1988; 169(3):733-6.
7. Finnbogason T, Jorulf H, Söderman E, Rehnberg L.
Anterior dynamic ultrasound and Graf’s examination
in neonatal hip instability. Acta Radiol. 2008;
49(2):204-11.
8. Koşar P, Ergun E, Ü􀇆 nlübay D, Koşar U. Comparison
of morphologic and dynamic US methods in
examination of the newborn hip. Diagn Interv Radiol.
2009; 15(4):284-9.
9. Rosendahl K, Markestad T, Lie R. Ultrasound in the
early diagnosis of congenital dislocation of the hip:
the significance of hip stability versus acetabular
morphology. Pediatr Radiol. 1992; 22(6):430-3.
10. Kosar P, Ergun E, Gökharman FD, Turgut AT, Kosar
U. Follow-up sonographic results for graf type 2A
hips association with risk factors for developmental
dysplasia of the hip and instability. J Ultrasound Med.
2011; 30(5):677-83.
11. Wientroub S, Grill F. Ultrasonography in developmental
dysplasia of the hip. J Bone Joint Surg Am. 2000;
82(7):1004.
12. Aronsson DD, Goldberg MJ, Kling TF, Roy DR.
Developmental dysplasia of the hip. Pediatrics. 1994;
94(2 Pt 1):201-8.
13. Dogruel H, Atalar H, Yavuz OY, Sayli U. Clinical
examination versus ultrasonography in detecting
developmental dysplasia of the hip. Int Orthop. 2008;
32(3):415-9.
14. Rosendahl K, Markestad T, Lie RT. Congenital
dislocation of the hip: a prospective study comparing
ultrasound and clinical examination. Acta Paediatr.
1992; 81(2):177-81.
The Archives of Bone and Joint Surgery
Volume 4, Issue 4
October 2016
Pages 371-375

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History

  • Receive Date: 21 February 2015
  • Revise Date: 12 May 2016
  • Accept Date: 05 July 2016

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