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Indications and Techniques for Ultrasonography of the Paediatric Orthopaedic Hip
Allison Kelliher1, Erin Welby2, Elyse Jensen1
1Orthopedic Surgery Department, Geisinger Health System, Wilkes-Barre, Pennsylvania, USA.
Insights
Paediatric hip ultrasound is a valuable diagnostic tool for infantile hip conditions. It aids in identifying acute and chronic hip pathologies without radiation exposure, benefiting orthopaedic practice.
Area of Science:
- Pediatric Orthopedics
- Diagnostic Imaging
- Musculoskeletal Ultrasound
Background:
- Ultrasound of the pediatric hip offers significant clinical utility.
- It serves as a crucial non-invasive imaging modality for evaluating infantile hip conditions.
Purpose of the Study:
- To detail clinical indications for infantile hip ultrasound.
- To describe standardized ultrasound assessment methods.
- To highlight the advantages of integrating ultrasound into pediatric orthopaedic practice.
Main Methods:
- Review of clinical indications for acute (infectious/inflammatory) and chronic (developmental dysplasia, Perthes disease) hip pathologies.
- Description of static (Graf Method) and dynamic (Harcke et al.) ultrasound techniques for infantile hip assessment.
- Emphasis on anatomical visualization and early pathology detection.
Main Results:
- Ultrasound effectively identifies early signs of hip pathology.
- It provides clear anatomical detail of the pediatric hip.
- Offers a diagnostic alternative to radiography, avoiding radiation exposure.
Conclusions:
- Infantile hip ultrasound is a versatile diagnostic tool with expanding applications.
- It aids in the early detection and management of various pediatric hip conditions.
- The technique is beneficial for pediatric orthopaedic surgeons.
Abstract:
Ultrasound of the paediatric hip has vast utility. The purpose of this paper is to outline the clinical indications for infantile hip ultrasound, describe the method by which it can be implemented, and describe the benefits of implementing such technology into orthopaedic paediatric practice. Indications for the use of paediatric ultrasound in the acute setting include infectious and inflammatory processes such as transient synovitis and septic arthritis, whereas indications in the chronic setting include developmental dysplasia, juvenile arthropathies, and Perthes disease. The following technique guide outlines the static (Classic Graf Method) assessment of the infantile hip while adding further development and instruction on the implementation of additional dynamic techniques promoted by Harcke et al. Ultrasound accurately identifies early stages of pathology; however, it also clearly outlines the anatomy of the paediatric hip without the disadvantage of radiologic exposure. As ultrasound techniques evolve, their utility also continues to expand. This paper is a useful tool for the paediatric orthopaedic surgeon to understand their diagnostic application.
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