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[Echography of the hip of the newborn infant]
Insights
Ultrasound screening for infant hip dysplasia is crucial. Graf
Area of Science:
- Pediatric Orthopedics
- Diagnostic Imaging
- Neonatal Care
Background:
- Infant hip dysplasia diagnosis relies on clinical exams and ultrasound (US).
- Graf's technique is a reproducible method for hip assessment in newborns.
- Risk factors for hip dysplasia include family history, malposition, and multiple births.
Purpose of the Study:
- To evaluate the efficacy of Graf's technique for infant hip dysplasia screening.
- To assess the incidence of hip dysplasia in at-risk and no-risk newborns.
- To determine the correlation between clinical examination and US findings.
Main Methods:
- Conducted 2164 hip US exams on newborns using Graf's technique.
- Classified infants into risk and no-risk groups based on predefined factors.
- Defined "borderline hips" (BLH) as Graf 2a+ and 2a- for analysis.
Main Results:
- Borderline hips (BLH) showed a tendency towards spontaneous normalization, with 7.9% worsening.
- Incidence of hip dysplasia was 9% in the risk group versus 5.1% in the no-risk group.
- Low agreement was found between clinical examination and US findings, highlighting the need for US screening.
Conclusions:
- Ultrasound screening is essential for early detection of hip dysplasia and prevention of juvenile coxarthrosis.
- Graf's technique provides a standardized and reproducible method for hip assessment.
- Early detection and appropriate therapy lead to successful hip normalization.
Abstract:
The authors report on their experience with 2164 US exams of the hip performed over last year on newborns, according to Graf's technique. The babies were divided into 2 groups at first examination: risk/no risk. We considered as risk factors: a positive family history, malposition in utero, abnormalities at birth, and being one of twins. Hips 2a+ and 2a- according to Graf were grouped as "borderline hips" (BLH), extrapolating them from negative and positive cases. BLH have generally shown a tendency to spontaneous normalization, although worsening of the condition was observed in 7.9% of cases. A high incidence of positivity (5.1%) was observed in the no-risk group, versus 9% in the risk group. Moreover, there was low agreement between clinical examination and US findings: the need for US screening is therefore pointed out, not only to promptly detect a decentered hip, but also to prevent the development of juvenile coxarthrosis in case of dysplasia. Premature babies were also studied, and those underweight for their gestational age: the incidence of positive subjects in this group (4.5%) was not higher than that found in the no-risk group (5.1%). We report on the phases of hip normalization as related to stage and therapy. Graf's technique, besides being at present the only reproducible one, represents a method common to all radiologist which allows hip measuring and staging.