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Ossification of femoral head: normal sonographic standards
Madhav Paranjape1, Avner Cziger, Kalman Katz
1Meera Hospital, Pune, India.
Insights
This study establishes normal reference standards for the femoral head ossification center in infants. Findings reveal ethnic variations in appearance timing, crucial for diagnosing hip disorders.
Area of Science:
- Pediatric Orthopedics
- Medical Imaging
- Developmental Biology
Background:
- Early detection of hip disorders is crucial for infant health.
- Establishing normative data for skeletal development aids diagnosis.
- The femoral head ossification center's appearance varies by ethnicity and age.
Purpose of the Study:
- To establish normal reference standards for the femoral head ossification center.
- To analyze variations based on age, sex, and gestational age.
- To investigate ethnic differences in ossification timing.
Main Methods:
- Sonographic hip examination of 1,800 healthy infants (900 Indian, 900 Israeli).
- Infants aged 2 to 24 weeks, with equal male and female representation.
- Data collected on the appearance of the femoral head ossification center.
Main Results:
- Femoral head ossification center appeared at 2 weeks (Israeli) and 8 weeks (Indian).
- Significant ethnic differences observed between 10-16 weeks (Indian: 81%+, Israeli: 22%-74%).
- Over 90% of infants showed ossification by 20-24 weeks; no gender differences noted.
Conclusions:
- Normal sonographic reference standards for femoral head ossification center appearance vary by ethnicity.
- Gestational age correlated with ossification timing in Israeli infants.
- These ethnic-specific standards aid in diagnosing pediatric hip disorders.
Abstract:
The aim of the study was to establish normal reference standards for the appearance of the femoral head ossification center according to age, sex, and gestational age. Sonographic examination of the hip was performed in 1,800 healthy Indian and Israeli infants (900 each) aged 2 to 24 weeks. There were an equal number of boys and girls. The ossification center was noted at 2 weeks of life in the Israeli infants and at 8 weeks in the Indian infants. However, from 10 to 16 weeks, it was noted in 81% or more of the Indian infants but only 22% to 74% of the Israeli ones. In both groups, between 20 and 24 weeks of age, it was noted in more than 90% of the infants. An association was found between gestational age at birth and chronologic age of appearance of the femoral head ossification center, but only among the Israeli infants. There were no differences between genders. Knowledge of the normal sonographic appearance of the femoral head ossification center by age and ethnicity will help clinicians in the diagnosis of hip disorders.