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Radiological outcome of innocent infant hip clicks
Tim P C Kane1, J R Harvey, R H Richards
1Department of Orthopaedics, Queen Alexandra Hospital, Portsmouth, UK.
Insights
Routine radiographic follow-up may not be necessary for infants with developmental dysplasia of the hip risk factors, specifically hip clicks, if initial ultrasound scans are normal. This study found normal 6-month radiographs in infants with clicks and normal ultrasounds.
Area of Science:
- Pediatric Orthopedics
- Diagnostic Imaging
- Developmental Dysplasia of the Hip
Background:
- Hip clicks in infants can be a sign of developmental dysplasia of the hip (DDH).
- Ultrasound is a common initial imaging modality for assessing infant hips.
- The necessity of routine radiographic follow-up for infants with isolated hip clicks and normal ultrasounds is debated.
Purpose of the Study:
- To evaluate the necessity of routine radiographic follow-up for infants presenting with hip clicks as the sole risk factor for DDH, provided initial ultrasound examinations are normal.
- To assess the radiographic outcomes at 6 months in this specific infant cohort.
Main Methods:
- A retrospective study identified 171 infants (193 hips) with isolated soft tissue hip clicks and normal initial hip ultrasound scans.
- A follow-up pelvic radiograph was obtained at 6 months of age.
- Key radiographic parameters including acetabular index, femoral ossific nucleus position, and Shenton's line were measured. Excluded were rotated radiographs.
Main Results:
- All measured radiographic parameters (acetabular index, femoral ossific nucleus position, Shenton's line) were within normal ranges for all included infants.
- No radiographic abnormalities indicative of developmental dysplasia of the hip were detected at the 6-month follow-up.
Conclusions:
- Infants with hip clicks as the sole risk factor for DDH, who demonstrate normal findings on initial ultrasound, exhibit normal radiographic outcomes at 6 months.
- Routine radiographic follow-up may be unnecessary in this specific population, potentially reducing unnecessary radiation exposure and healthcare costs.
Abstract:
Radiographic follow-up is questioned for infants with hip clicks who have normal results from ultrasound scan examination of the hips. Infants whose sole risk factor for developmental dysplasia of the hip was a soft tissue hip click who had a normal ultrasound scan on initial assessment were identified. A follow-up 6-month pelvis radiograph was assessed. The acetabular index, position of femoral ossific nucleus and Shenton's line were measured. Rotated radiographs were excluded. One hundred and seventy-one infants (193 clicking hips) met the criteria for inclusion. All parameters measured were within normal ranges. In this study infants with hip clicks and a normal hip ultrasound scan on initial assessment had a normal radiograph at 6 months.