Musculoskeletal ultrasound: a useful tool for diagnosis of hip developmental dysplasia

Abstract

Developmental dysplasia of the hip (DDH) is one of the most common congenital abnormalities of the musculoskeletal apparatus in newborns. The aim of this study was to analyze the contribution of ultrasonography in the detection of DDH in newborns and infants, identifying the regional incidence of this pathology in the central area of Romania, emphasizing the risk factors that underlie DDH etiopathogenicity.This article represents a retrospective study of 847 newborns and infants examined in the Imagistic Department of a medical center from the central area of Romania, between January 1 and December 31, 2016. The ultrasound examinations were performed for the bilateral coxofemoral joints, using the method and technique described by Graf. For subjects born in the same medical center, data regarding mother's age, birth weights, and type of delivery (natural vs. caesarian section) were statistically analyzed.In our study group, the frequency of ultrasound diagnosis obtained from the examinations of right and left hips showed that the most frequent stage was type IA, and the rarest stage was III. The IA stage of right coxofemoral joints (87.3%) was higher than in the left coxofemoral joints (87.2%). The incidence of hip dysplasia (type III) diagnosed with ultrasound examinations in subjects from the central area of Romania was 0.2% (0.1% in both hips and 0.1% for the left coxofemoral joint).The musculoskeletal ultrasound examination is effective in early detection of hip dysplasia. The implementation of national and regional programs that promote indications, risk factors, and the screening age for DDH in both rural and urban areas could be a step forward in the early diagnosis of hip dysplasia for newborns and infants. The low incidence of DDH from our study group is not able to identify the role of advanced age of the mother, high birth weight of the newborn, or caesarean section as risk factors involved in the etiology of hip dysplasia. The implementation of national and regional programs that promote the musculoskeletal ultrasound as a screening imagistic investigation for DDH, in both rural and urban areas, could be a step forward in the early diagnosis of hip dysplasia for newborns and infants.

Incidence of Neonatal Developmental Dysplasia of the Hip and Late Detection Rates Based on Screening Strategy

“…Our initial search retrieved 1899 results, and we assessed 203 full texts. Ultimately, 76 studies 1 , 4 , 5 , 6 , 8 , 18 , 19 , 20 , 21 , 22 , 23 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , …”

“…A total of 60 studies 1 , 4 , 5 , 8 , 18 , 19 , 20 , 21 , 22 , 23 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , 75 including 8 670 492 newborns assessed the incidence of early-detected DDH. Of these, 10 studies…”

Epidemiological investigation and ultrasonic diagnosis of developmental dysplasia of the hip in Chinese infants

“…[ 14 – 18 ] This trend may be related to the relaxation of the hip joint capsule and surrounding ligaments in female infants due to endocrine factors. [ 19 ] In addition, DDH incidence was higher in the left hip joint than in the right hip joint. [ 20 ] This may be because most fetuses are in the left occiput anterior position at the time of birth.…”

An evaluation of clinical and ultrasound results of Pavlik harness treatment for developmental dysplasia of the hip

“…Ultrasound also plays an important role in diagnosing and treating this disease and is useful in monitoring closed reduction techniques [ 18 ]. Late diagnosis of DDH can lead to lameness and walking on the toes [ 19 ].…”