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Ultrasonography in developmental dysplasia of the hip: what have we learned?
Jennifer Bracken1, Michael Ditchfield
1Department of Medical Imaging, Monash Children's, 246 Clayton Road, Clayton, Victoria, 3168, Australia.
Insights
Developmental dysplasia of the hip (DDH) diagnosis and management remain controversial. This review details the history and current status of ultrasound (US) imaging for DDH, offering insights for radiologists.
Area of Science:
- Pediatric Radiology
- Orthopedic Imaging
- Developmental Biology
Background:
- Developmental dysplasia of the hip (DDH) is a spectrum of hip instability.
- Its natural history, diagnosis, and management are not fully understood.
- Controversy exists regarding optimal imaging and treatment strategies.
Purpose of the Study:
- To review the historical evolution of ultrasound (US) imaging for DDH.
- To summarize recognized US methods for DDH assessment.
- To discuss current controversies and evidence in US screening for DDH.
Main Methods:
- Historical review of ultrasound imaging techniques for DDH.
- Synthesis of widely recognized US examination methods.
- Analysis of scientific evidence and practice variations in DDH screening.
Main Results:
- Ultrasound has become a key imaging modality for DDH.
- Various US techniques exist, with ongoing debate on standardization.
- Conflicting recommendations from major task forces highlight practice variations.
Conclusions:
- Ultrasound imaging has significantly impacted DDH diagnosis.
- Standardization of US techniques and screening protocols is needed.
- Further research is required to resolve controversies in DDH management.
Abstract:
Developmental dysplasia of the hip (DDH) is an important but poorly defined entity, the natural history of which is incompletely understood. The term encompasses a disease spectrum ranging from a stable hip with a mildly dysplastic acetabulum to complete hip dislocation. Much controversy surrounds the diagnosis, imaging and management of this condition. We present a review of the history of US imaging of DDH from the radiologist's perspective, summarising the most widely recognised US methods described to date. We discuss controversies in the approach to US examination, with particular emphasis on current opinions. The existing scientific evidence for and variations in the practice of US screening for DDH, including recommendations from the United States Preventive Services Task Force and the ESPR DDH Taskforce Group respectively, are discussed.
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