Imaging Methods Used for Children with Hip Dysplasia

Ht, Harcke

doi:10.1097/01.blo.0000162411.55355.c8

Cited by 27 publications

(11 citation statements)

References 26 publications

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“…Again, excluding articles which reviewed the literature, ultrasounds were performed in the first week after birth in six studies [1, 16, 25, 27–29], the second week in two studies [2, 26], and in the first 8 weeks in two studies [26, 30]. Finnbogasan [15] examined ultrasound results from birth until 3 months.…”

Section: Resultsmentioning

confidence: 99%

Early dynamic ultrasound for neonatal hip instability: implications for rural Australia

Schoo

Walters

2017

BMC Pediatr

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BackgroundNeonatal instability of the hip (NIH), where the femoral head can move away from the acetabulum, in the first weeks of life, is an important risk factor for developmental dysplasia of the hip (DDH). In rural areas in Australia, there is a recent trend to increased late diagnosis of DDH. Clinical screening of infant hips, a common practice in Australia, is experience dependent. Best practice early screening techniques are still debated with different techniques and timing used internationally. This systematic review examines early dynamic ultrasound (eDUS) screening for hip instability in the first 6 weeks after birth, and the early interventions informed by these findings and considers the findings for the context of rural Australia.MethodsThe Cochrane Library, Medline, CINAHL and PEDro were searched for original research or systematic reviews, and clinical studies 1998 to 2015 involving dynamic ultrasound. Critical Appraisal Skills Programme tools were used to appraise the studies.ResultNineteen studies were included. Early Dynamic Ultrasound (DUS) is consistently described as a reliable assessment of NIH. Early DUS is recommended for risk factors including geographical areas of high prevalence. Approaches to early intervention of hips with excessive movement are somewhat discipline-related and include: primary prevention (advice), secondary prevention (abduction supports), and conservative management (removable splints).ConclusionsIn the context of increased prevalence of DDH in rural Australia, contemporary evidence suggests that introduction of early DUS could provide rural infants with more effective screening than clinical examination alone. Targeted early advice about posturing and simple removable supports to abduct infant hips could prevent some cases of DDH in rural Australia.

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Section: Resultsmentioning

confidence: 99%

Early dynamic ultrasound for neonatal hip instability: implications for rural Australia

Schoo

Walters

2017

BMC Pediatr

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“…Although ultrasonography is informative about the position of the femoral head in newborns, the accuracy of this technique drastically decreases in older children with calcified structures. In young children, it is possible to use ultrasound to assess the hip after reduction, but it is difficult once a spica has been applied [5]. MRI is a superior soft-tissue contrast resolution which allows differentiation between articular structures such as bone, hyaline and fibrous cartilage, ligaments, joint capsule, intra-articular tissues and fluids [14][15][16].…”

Section: Discussionmentioning

confidence: 99%

Utility of magnetic resonance imaging (MRI) after closed reduction of developmental dysplasia of the hip

Bachy

Thévenin-Lemoine

Rogier

et al. 2012

Journal of Children's Orthopaedics

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Purpose Magnetic resonance imaging (MRI) has been successfully used in the determination of the adequacy of the surgical reduction of congenitally dislocated hips in children. We present the results of a prospective series of patients treated conservatively. MRI was performed in all hips after positioning was deemed adequate on radiographs after spica cast application. The goal of this study was to evaluate the usefulness of MRI in this indication.

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“…View 1 in the mid-acetabular plane at rest plus view 4 with and without stress are used [3, 10–12]. This recommendation is also accepted by the medical associations [13].…”

Section: Harcke Methodsmentioning

confidence: 99%

“…It is possible to make a multiplanar examination and to determine the position of the femoral head with respect to the acetabulum by using a real-time ultrasonography [2]. Ultrasonography can detect the hip problems that can be missed by clinical and radiographic examinations [2, 3]. As early and accurate diagnosis of DDH is believed to be the most important point for satisfactory treatment, hip ultrasonography has become the most commonly used diagnostic tool for DDH during early infancy, and for many years.…”

Section: Introductionmentioning

confidence: 99%

Use of ultrasonography in developmental dysplasia of the hip

Ömeroğlu

2014

Journal of Children's Orthopaedics

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PurposeUltrasonography has been used as a diagnostic tool in developmental dysplasia of the hip (DDH) during early infancy since the early 1980s. The aim of this review article is to summarise the technique, benefits and shortcomings of four infantile hip ultrasonography methods, focusing mainly on the Graf method, and to assess the effectiveness of ultrasonographic newborn hip screening programmes.MethodsSeveral infantile hip ultrasonography methods have been defined to assess the relationship between the femoral head and acetabulum. The Graf, Harcke, Terjesen and Suzuki methods are the universally known ones. The Graf method is composed of a quantitative classification system, while the Harcke and Suzuki methods have qualitative definitions and the Terjesen method contains both quantitative and qualitative descriptions.ResultsAlthough the results of several studies assessing the sensitivity and consistency of the ultrasonography methods have still not proven a clear dominance of one of these techniques, the primary advantage of the Graf method is that it has a standardised examination technique, as well as a very well defined numeric hip typing system. The importance of newborn hip screening has been universally accepted, but there is still no strong evidence regarding the superiority of either universal (screening of all newborns) or selective (screening of high-risk newborns) ultrasonographic newborn hip screening programmes.ConclusionsAn effective ultrasonographic method should include simple, precise, quantitative and consistent definitions for a proper examination and diagnosis. Both universal and selective ultrasonographic newborn hip screening programmes have significantly decreased the rate of late detected DDH and lessened the need for surgical treatment.

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Imaging Methods Used for Children with Hip Dysplasia

Cited by 27 publications

References 26 publications

Early dynamic ultrasound for neonatal hip instability: implications for rural Australia

Early dynamic ultrasound for neonatal hip instability: implications for rural Australia

Utility of magnetic resonance imaging (MRI) after closed reduction of developmental dysplasia of the hip

Use of ultrasonography in developmental dysplasia of the hip

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