Practical approach to ultrasound of the hip in developmental dysplasia

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Although computed tomography is indicated to assess developmental dysplasia of the hip when the patient is in a cast, and magnetic resonance imaging is the modality of choice to evaluate for avascular necrosis during treatment, ultrasound remains the primary imaging study for making the diagnosis of DDH. Sonography is performed at rest, during motion, and with stress. The technique is simple, but for the newcomer it can be challenge, because it requires the ability to mentally reconstruct the anatomy from the available 2-dimensional images. It has been recommended that the radiologist perform 100 such examinations, including normal and abnormal patients to develop an adequate level of competence.21 Gross dislocations are easy to diagnose. The problem gets more difficult when the dysplasia is only moderate because the findings may be subtle. In such cases, I recommend the combined use of several techniques (as described above): (a) conventional standard images; (b) dynamic study; (c) acetabular angle measurements; and (d) acetabular coverage of the femoral head. In communicating with the referring physician, pediatrician, or orthopedic surgeon, it is important to remember that most of the minor ultrasound findings will resolve spontaneously. The decision to initiate treatment should result from the correlation of ultrasound and clinical findings.

Original languageEnglish (US)
Pages (from-to)23-33
Number of pages11
Issue number1
StatePublished - 1998

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging


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