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[Echography of the hip in the newborn. 1507 cases]
G Riboni1, S Serantoni, M De Simoni
1Servizio di Radiologia, Istituto Ospedaliero Provinciale per la Maternità, Milano.
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Ultrasound (US) screening using Graf
Area of Science:
- Pediatric Orthopedics
- Diagnostic Imaging
Background:
- Neonatal hip screening is crucial for early detection of hip dysplasia/dislocation.
- Clinical examination alone has limited sensitivity for identifying pathologic hips.
Purpose of the Study:
- To evaluate the effectiveness of ultrasound (US) examination in screening for hip dysplasia/dislocation in newborns.
- To compare the diagnostic value of Graf's technique versus clinical examination.
Main Methods:
- A cohort of 1507 infants underwent clinical and US examinations using Graf's technique.
- Infants were classified by US hip type, clinical findings, and risk factors.
- A protocol of orthopedic and US follow-up controls was implemented.
Main Results:
- Seventeen infants (1.1%) were identified as having pathologic hips requiring treatment.
- No statistically significant difference in pathologic hip incidence was found between risk and no-risk groups.
- Clinical examination showed low sensitivity in detecting hip abnormalities.
Conclusions:
- Ultrasound examination, particularly Graf's morphologic method, is a valuable and effective screening tool for neonatal hip dysplasia/dislocation.
- Graf's method is recommended for US screening of infant hips during the neonatal period.
Abstract:
The authors report the data relative to 1507 infants studied with clinical and US examination, in the neonatal period, in order to exclude hip dysplasia or dislocation. US examination was carried out according to Graf's technique and the newborns were classified according to US hip type, to clinical examination and to possible risk factors. The patients were included in a protocol including orthopedic and US controls. Seventeen treated infants were considered as pathologic. Ten of them had IIc or D hips at birth; the other 7, with IIa hips at birth, presented a X-ray pathologic hip after the 4th month of life. At about one year of age all infants could normally walk, except for one who was being treated with harness. No statistically significant differences were observed between the number of pathologic infants in the risk group (1.7%) and that in the no-risk group (0.8%). Clinical examination of the newborn has low sensitivity in detecting pathologic hips. On the basis of their results, the authors believe US examination of the newborn to be a valuable screening method to diagnose hip dysplasia/dislocation. Moreover, Graf's morphologic method is the best one for US screening of the hip in the neonatal period.