Consistency of Indices Obtained via Hip Medial Ultrasound and Magnetic Resonance Imaging in Reduction and Spica Cast Treatment for Developmental Dysplasia of the Hip

Is Hip Medial Ultrasound More Accurate Than Radiography for Determining the Status of Hip Reduction in Children Treated With a Spica Cast? A Retrospective Diagnostic Accuracy Study

“…In this study, we used hip medial ultrasound to identify the acetabulum coronal mid sectional plane, measure the TFD, and quantify the relative positions of the femoral head and acetabulum to determine the reduction status more accurately. As an index, in a previous study [23], the TFD was confirmed to have good consistency on the acetabulum coronal mid sectional plane by ultrasound and on the median coronal plane by MRI. We set the TFD threshold for reduced and uncertain-status hips as 10 mm to quantify hip reduction.…”

Outcome Prognostic Factors in MRI during Spica Cast Therapy Treating Developmental Hip Dysplasia with Midterm Follow-Up

“…Published cohorts have ranged in size from 21-110 patients, allowing for a comparison with the results in this cohort of 49 patients [15,[36][37][38][39][40]. The mean age at time of starting treatment in this study was 9.9 weeks and therefore far below most reported ages, which generally started treatment around 6 to 24 months of age or even older [20,[36][37][38]. The poorer outcome higher rates of AVN in some studies might be associated with older age at time of immobilization [39,[41][42][43].…”

“…Some prefer leaving window in the cast to perform a transinguinal ultrasound [ 14 , 15 , 16 ]. This additional window reduces the stability of the cast, which is why others prefer magnetic resonance imaging (MRI) to evaluate the position of the femoral head after closed reduction and cast application [ 17 , 18 , 19 , 20 , 21 ]. Further available imaging methods are X-ray or computer tomography (CT) scans [ 22 , 23 , 24 ].…”

CORR Insights®: Is Hip Medial Ultrasound More Accurate Than Radiography for Determining the Status of Hip Reduction in Children Treated With a Spica Cast? A Retrospective Diagnostic Accuracy Study

“…However, this cutoff point needs to be validated. The 10-mm TFD showed high interobserver and intraobserver agreement in a recent report [13], but the TFD parameter might change based on the reduction technique. An arbitrary value (3 mm) was added to the classic TFD (7 mm) for the thickness of the acetabular soft tissue component to arrive at this 10-mm cutoff.…”