The role of ultrasound imaging in congenital hip dislocation.

Abstract

Congenital hip dislocation (CHD), also referred to as developmental dysplasia of the hip (DDH), is a condition in which the neonate is born with an abnormal formation of the hip joint, in which the femoral head is not stable within the acetabulum. Adding to this the ligaments of the hip joint may also be loose and stretched. The degree of instability or looseness varies by either having the baby born with the ball of the hip subluxed or otherwise completely dislocated (MedicineNet, 2000). Clinical evaluation for CHD is part of routine neonatal screening by using Ortolani and Barlow manoeuvers (Larson et al, 2006). If during the clinical examination an audible clunk of the femoral head is heard, instability of the hip is suspected. Then the next examination in line would usually be an ultrasound examination. The purpose of this study was to identify the role of ultrasound imaging in CHD. In this study US proved to be the most accurate imaging modality in detecting CHD in the first months of life, as many of the bones making up the hip joint are not yet ossified and are mainly made up of cartilage. Besides this, ultrasound is also beneficial as there is no ionizing radiation involved (Wheaton Resource Corp. 2009). Other imaging modalities such as conventional radiography, computed tomography (CT) and magnetic resonance imaging (MRI) may also be used in the management of CHD. Based on the findings, a number of conclusions and recommendations are presented and proposed respectively.