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[A sonographic study of the hips in neonates and infants]
1Department of Orthopaedic Surgery, Nagoya University School of Medicine, Aichi, Japan.
Insights
Ultrasonography is a useful screening tool for infant hip dislocation, accurately diagnosing dislocations and subluxations. While it misses some hip dysplasia cases, it avoids radiation risks associated with X-rays.
Area of Science:
- Pediatric Orthopedics
- Diagnostic Imaging
Background:
- Congenital hip dislocation requires early detection for effective treatment.
- Conventional radiography (X-ray) is a standard diagnostic tool but involves radiation exposure.
- Evaluating alternative imaging modalities like ultrasonography is crucial for pediatric diagnostics.
Purpose of the Study:
- To compare the diagnostic accuracy of ultrasonography with X-ray for detecting hip abnormalities in neonates and infants.
- To assess the utility and feasibility of ultrasonography as a screening method for congenital hip dislocation.
Main Methods:
- A comparative study involving 902 infant hips (age 1 day to 18 months).
- Diagnosis of hip abnormalities (dislocations, subluxations, dysplasia) using conventional X-ray.
- Sonographic evaluation performed using Graf's method.
Main Results:
- X-ray identified 37 dislocations, 17 subluxations, and 88 dysplastic hips.
- Ultrasonography successfully diagnosed all identified dislocations and subluxations.
- Approximately 50% of hip dysplasia cases were not distinguishable from normal hips via ultrasonography.
- Ultrasonography demonstrated superior visualization of cartilaginous structures and soft tissues in infants under three months old.
Conclusions:
- Ultrasonography is a valuable screening tool for congenital dislocation of the hips in infants.
- The method is particularly effective for early detection in neonates and young infants due to clear visualization of soft tissues.
- Ultrasonography offers a radiation-free alternative to X-ray for initial hip screening in this population.
Abstract:
A comparative study between X-ray and ultrasonography was carried out in the hips of neonates and infants, for the purpose of evaluating the usefulness and possibility of the latter method. We studied 902 hips between the ages of one day and eighteen months. Thirty-seven dislocations, seventeen subluxations, and eighty eight dysplastic hips were detected by X-ray. A sonographic study was done by Graf's method. All dislocations and subluxations could be diagnosed by ultrasonography too, but about half of the dysplastic hips could not be distinguished from normal hips by this method. This method is more useful than X-ray for patients under the age of three months, since the cartilaginous femoral head and the soft tissues around the hip could be clearly visualized. Ultrasonography thus appears to be a useful screening method for congenital dislocation of the hips without the hazard of radiation caused by X-ray.