Related Experiment Video
Updated: Oct 20, 2025
In Vivo Quantification of Hip Arthrokinematics during Dynamic Weight-bearing Activities using Dual Fluoroscopy
Published on: July 2, 2021
[CLINICAL DIAGNOSTICS OF DDH AND PECULIARITIES OF HIP JOINT DEVELOPMENT IN CHILDREN THROUGHOUT THE FIRST YEAR OF
V Zinchenko1, M Kabatsii1, I Hertsen1
1State Institution «Institute of Traumatology and Orthopedics National Academy of Medical Science of Ukraine», Department of Joint Diseases in Children and Adolescents, Kyiv, Ukraine.
Insights
Selective ultrasound screening for developmental dysplasia of the hip (DDH) in infants is less effective than general screening. This study highlights seasonal variations in hip development and the limitations of risk-factor-based screening for DDH.
Area of Science:
- Pediatric Orthopedics
- Diagnostic Imaging
- Developmental Pediatrics
Background:
- Developmental Dysplasia of the Hip (DDH) is a condition requiring early detection for effective management.
- Selective screening based on clinical signs and risk factors is a common approach, but its efficacy is debated.
- Understanding typical hip joint maturation and potential influencing factors like seasonality is crucial for accurate diagnosis.
Purpose of the Study:
- To evaluate the reliability and feasibility of selective ultrasound screening for DDH in at-risk infant populations.
- To identify specific patterns in hip joint maturation and ossification.
- To assess the influence of birth seasonality on hip joint development.
Main Methods:
- Ultrasound hip examinations using the R. Graf method were performed on 1539 infants (1 year) and 812 newborns.
- Infants were categorized into groups with and without clinical signs/risk factors for DDH.
- Seasonal birth groups (summer, autumn, winter, spring) were analyzed for hip development indicators, including the alpha angle.
Main Results:
- Selective screening of risk groups missed 12% of DDH cases, indicating lower sensitivity compared to general screening.
- Infants born in winter and autumn showed lower mean alpha angle values, suggesting potential seasonal influence on hip development.
- A weak correlation was observed between risk factors/clinical signs and acetabular development in the first year of life.
Conclusions:
- General ultrasound screening is more expedient for infant hip assessment than selective screening of risk groups.
- Seasonal factors appear to influence hip joint development, with specific patterns observed based on birth season.
- The findings underscore the need for comprehensive screening protocols to ensure timely diagnosis and treatment of DDH.
Abstract:
The aim is to determine the reliability and feasibility of using the system of selective ultrasound screening of children in groups at risk of DDH and to determine the peculiarities of the hip joints maturation. The hip joints were examined in 1539 children of the first year of life and 812 newborns. All children were divided into two groups to assess the effectiveness of the system of selective ultrasound screening of the hip joints, identified by clinical signs and risk factors DDH - with risk factors and (or) clinical signs of DDH and without risk factors and clinical signs of DDH. The study of the developmental characteristics of the hip joints is based on the analysis of sonographic indicators of the hip joints in children from birth to 10 months old. Also, to assess the hip joints at birth, all children who were examined in the maternity hospital were divided into four groups according to seasonality: those born in summer - 116, in autumn - 208, in winter - 282 and in spring - 206 people. The children underwent ultrasound examination of the hip joints according to R. Graf and determination of clinical signs and risk factors of DDH. Statistical processing was performed in Microsoft Excel and StatSoft Inc. STATISTICA. The obtained statistical data allow us to draw conclusions about the development and ossification potential of the acetabulum. A healthy hip joint has significant development potential in the first 3 months of life. The assessment of the condition of the hip joints of newborns in different seasons of the year showed that the discovered influence of seasonal factors on the development of the hip joints. Mean alpha angle values are lower in infants born in the winter and fall months and high in infants born in spring and summer. An insignificant correlation was revealed between risk factors and clinical signs of DDH and the state of development of the acetabulum in children of the first year of life. The expediency of the system of general ultrasound screening of the infants hip has been substantiated, given that when using the system of selective screening of risk groups, 12% (every eighth children) of DDH in children remains undiagnosed.
