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Related Experiment Videos

Late presenting dislocation of sonographically stable hips.

David P Gwynne Jones1, John D Dunbar, Jean-Claude Theis

  • 1University of Otago, Dunedin, New Zealand. david.gwynne-jones@stonebow.otago.ac.nz

Journal of Pediatric Orthopedics. Part B
|June 6, 2006
PubMed
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Ultrasound may miss developmental hip dislocations even in stable hips. Infants with initial instability require follow-up pelvic X-rays at 4-6 months for accurate diagnosis.

Area of Science:

  • Pediatric Orthopedics
  • Developmental Dysplasia of the Hip
  • Diagnostic Imaging

Background:

  • Developmental Dysplasia of the Hip (DDH) is a common condition.
  • Early diagnosis and treatment are crucial for optimal outcomes.
  • Ultrasound is a primary imaging modality for infants under six months.

Observation:

  • Seven cases of developmental hip dislocation were observed in five infants (6-22 months).
  • These dislocations occurred despite previous ultrasound findings of reduced and stable hips.
  • Four hips initially diagnosed with clinical instability (Barlow positive) at birth had stabilized by ultrasound scan (16-45 days).

Findings:

  • Reduced and sonographically stable hips at 2-6 weeks of age can still dislocate later.
  • Femoral head coverage in affected hips ranged from 36% to 56%.

Related Experiment Videos

  • One hip showed minimal laxity on stress sonography.
  • Implications:

    • Ultrasound findings of stability do not exclude the possibility of subsequent dislocation.
    • Infants with a history of neonatal hip instability warrant further investigation with pelvic radiography at 4-6 months.
    • This highlights the limitations of early ultrasound in predicting long-term hip stability.