Ultrasonography in congenital dislocation of the hip. Simultaneous imaging of both hips from in front

Abstract

We describe a new technique for examining the infant hip using ultrasound. Both hips are imaged simultaneously via an anterior approach. The examination can be done with the hip either extended or flexed and abducted. The method has three advantages: 1) since both hips are imaged simultaneously, lines can be drawn to assist in determining the relationship between the femoral head and the pelvis; 2) proximal, anteroposterior and lateral displacement of the femoral head can all be demonstrated; 3) the method is applicable to the infant in a harness or a plaster cast to demonstrate maintenance of reduction of a dislocated hip. The usual direction of dislocation of the femoral head was anterior and lateral. Proximal migration was also observed in cases with more severe dislocation. In flexion, the dislocated head of the femur often moved posterior to the acetabulum. Of 1276 hips, in 638 infants aged from three weeks to one year, 49 showed congenital dislocation. The accuracy of our anterior method of sonography in diagnosing congenital dislocation of the hip compared well with the method of Graf and with radiography.

Correlation of femoral head coverage and Graf α angle in infants being screened for developmental dysplasia of the hip

“…Harcke et al described a dynamic technique in which the hip joint was moved during the examination session [7]. Suzuki et al developed a method for imaging both hip joints simultaneously from the front, and demonstrated the location of the femoral heads [11].…”

Use of ultrasonography in developmental dysplasia of the hip

“…This method was initially defined by Shiego Suzuki and associates from Shiga, Japan in the early 1990s and includes the simultaneous examination of both hips using a large linear probe by an anterior approach [20]. A standard plane, showing both pubic bones and femoral heads, is obtained by placing the large linear probe on the pubis while the patient lies supine with the hips extended.…”

The mechanical cause of congenital dislocation of the hip joint: Dynamic ultrasound study of 5 cases

“…The probe was put on the hip joint transverse to the axis of the trunk and the section of unilateral hip joint was observed during knee motion. An anterior approach (Suzuki et al 1991) was used in order to observe the femoral head motion with an extended hip (Figure 2). …”