Role of Ultrasound in Evaluation of Developmental Dysplasia of the Hip in Infants

Background/Aim: The present study was directed to investigate the accuracy of ultrasound (USG) in early detection of developmental dysplasia of the hip (DDH) to prevent permanent complications. Material & Methods: A total of 276 infants was investigated; their ages range from 1 - 6 months. Patients referred from the clinic based on clinical assessment (mainly Barlo & Ortolani maneuvers). Then the patient’s hips were examined by expert radiologists in USG scan. After that, dynamic (coronal and transverse) & static ultrasound views evaluated by the same radiologist using Graf’s criteria. Infants with abnormal ultrasound findings suggestive of DDH were followed up after 4 - 6 weeks by the same investigator to monitor the progress. At the same time, the patient referred to a specialist for conservative management from the first positive findings. Results: Among the 276 referred patients, infants with normal stable hips (Graf Type I and Type II a+) were 221 (80%), 155 of them were female and 66 male infants. Infants with unstable hips based on Graf’s criteria (Type II a-, II b, II c and Type III a) were 55 (20%). Out of 55 with abnormal findings, the affected hips on both sides, right and left were: 5 cases (1.8%), 7 (2.5%) and 43 hips (15.5%) consecutively. Out of 55 infants affected; 3 referred to tertiary centers for further surgical management while 52 managed conservatively. Conclusion: Delayed treatment rates of DDH and complications could be reduced by the usage of the USG after the first month of life. In addition to physical assessment, USG for high-risk infants will provide more accurate diagnosis and minimize complications.