Neonatal Hip Ultrasound

Neonatal Hip Ultrasound

Developmental Dysplasia of the Hip is a congenital disorder in which the acetabulum is underdeveloped or there is dislocation of the hip. Incidence of DDH is 1.5 in 1,000 it is more seen in females with a ratio of about 4:1.

Indications
Abnormal Physical
Hip Click
Breech Presentation
Oligohydramnios
Family history or follow up for known Dysplasia

Scanning

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With the patient in lateral decubitus, dynamic imaging is obtained by performing Barlow (adduction or flexion) and Ortolani (abduction) maneuvers. Via the acetabulum you measure the Alpha and Beta angles.

Normal measurements are Alpha >60 degrees and Beta >55 degrees.

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Protocol

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Coronal

image1

 

Images in neutral, adduction (flexion) and abduction (extension)

Measure the beta and alpha angles, asses acetabular morphology and for subluxation.

Transverse

image4

 

Images in neutral, adduction (flexion) and abduction (extension)

 

Graf Classification

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Sources:

http://www.aium.org/resources/guidelines/hip.pdf

https://radiopaedia.org/articles/graf-method-for-ultrasound-classification-of-developmental-dysplasia-of-the-hip

http://pediatrics.aappublications.org/content/125/1/e9

http://radiologykey.com/small-part-and-hip-ultrasound/

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