European Journal of Therapeutics
Original Article

Optimal Timing of Ultrasound for the Diagnosis of Developmental Hip Dysplasia in Infants: 1st or 5th Week?

1.

Department of Radiology, Ömer Halisdemir University, Niğde, Turkey

2.

Department of Radiology, Yüksek Ihtisas Post-Graduate Teaching and Research Hospital, Ankara, Turkey

Eur J Ther 2021; 27: 224-229
DOI: 10.5152/EurJTher.2020.19075
Read: 40 Downloads: 34 Published: 31 March 2020

Objective: Ultrasonography (US) is a useful, easy and accurate screening method for neonatal developmental dysplasia of the hip (DDH). The purpose of this prospective, cross-sectional and interventional study is to determine the optimal timing of US to evaluate the hip joints in newborns and to find the concordance or discordance between two radiologists for this evaluation.

Patients and Methods: Consecutive 27 [18 (66.7 %) girl, 9 (33.3 %) boy] newborns were enrolled into the study. Two experienced radiologist (Ş.T.-M.Ö.) performed standard hip US examinations at 1st and 5th weeks of age according to the method described by Graf. The relationship between femur head and acetabulum was assessed. The results between 1st and 5th weeks were compared. In addition, the agreement between the two radiologists was evaluated.

Results: None of the babies were found to have subluxation or dislocation by clinical examination. The US measurements regarding the ossification and the diameter of femur head, bony and cartilaginous roof at 1st and 5th weeks were similar (for all, p > 0.05). In our serie, there was no hip defined as Graf’s type 2b or higher. 4 (14.8 %) right hips and 6 (22.2 %) left hips (totally 10 hips) were classified as Graf type IIa (physiologically immature) at 1st week. 7 hips spontaneously returned to normal during the following four weeks. However, 2 (7.4 %) right and 1 (3.7 %) left hip joints were still type IIa at 5th week evaluation. Graf type of hips were reported as similar by 1st and 5th week measurements (n = 54, p > 0.05, for each). There was no interobserver variability between two radiologists in respect of Graf’s classification (Kappa > 0.81). The blunt/round shape of acetabular rim defined in 10 hips at 1st week was improved to angular shape in 8 hips at 5th week (p = 0.008).

Conclusion: Early US screening can diagnose some hip disorders in babies with normal physical examination. Most of the abnormal findings detected at 1st week US screening recovered spontaneously at 5th week. Infants with normal US measurements at 1st week may be excluded from follow-up, and those with suboptimal findings may be monitored by physical examination and repeated US.

How to cite: Turcan Ş, O¨zdemir M, Edis-O¨zdemir FA. Optimal Timing of Ultrasound for the Diagnosis of Developmental Hip Dysplasia in Infants: 1st or 5th Week? Eur J Ther 2021; 27(3): 224-229.

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