Ultrasound of the hip joints for newborns and infants

A common, painless procedure that is vital to ensuring the healthy development of newborns and infants is hip joint ultrasound. This quick scan aids in the early detection of any possible problems, such as hip developmental dysplasia, a disorder in which the hip joint is malformed. The ability to treat a child promptly after diagnosis can have a significant impact on their future mobility.

Although having their baby undergo an ultrasound can cause anxiety in many parents, the process is safe and non-invasive. In order to keep the baby comfortable, it is usually done when they are quiet and motionless. Resolving any doubts and preparing families for what to expect can be accomplished by explaining the significance of this test.

Aspect	Details
Purpose	To check for hip dysplasia or other abnormalities in newborns and infants.
When to Perform	Typically done in the first few months after birth, especially if there"s a family history of hip issues or if the baby shows symptoms.
Procedure	The baby lies on an exam table, and a technician uses a gel and ultrasound device to capture images of the hip joints.
Duration	Usually takes about 15-30 minutes.
Preparation	No special preparation is needed; the baby can eat and drink as usual.
Results	Results are usually available immediately, and a report is sent to the pediatrician for follow-up.

About diagnostics

The first screening, given to children at one month of age, includes an ultrasound of the hip joints. Children are not charged for participation in this study. If an orthopedic specialist notices certain abnormalities in a child’s joint development during a visual examination, he may recommend such a diagnostic examination at any age.

You can evaluate the size, position, and condition of the joints with such an ultrasonic examination. Hip subluxation and pre-luxation most frequently happen in childhood. A complete dislocation happens less frequently. During a painless, non-invasive ultrasound examination procedure, all these stages are easily diagnosed.

When it comes to hip dysplasia, the physician can accurately assess the pathology’s severity, which is important in order to recommend a suitable course of treatment. Refusing a routine screening ultrasonography of the hip joints carries a risk because the pathology that is already present may go undiagnosed for an extended period of time. Lameness, movement disorders, and disability are among the very serious outcomes that can result from delayed or nonexistent treatment.

• premature babies;
• children in whose family there are relatives with joint pathologies;
• children who were in a breech presentation during pregnancy;
• babies who were carried and born in large cities, in areas with unfavorable environmental conditions;
• babies born from pregnancies accompanied by oligohydramnios, severe toxicosis, vitamin deficiency and anemia.

A specific referral for this kind of evaluation is typically made when one of the following symptoms is present:

• skin folds on the legs of the newborn are not symmetrical;
• the baby"s hips are difficult to spread, limited;
• the joints create a crunch or click when moving the legs;
• the baby"s legs are not just in tone, the doctor qualifies it as hypertonicity;
• the child was not born alone – he is one of twins or triplets;
• the baby has a birth injury, neurological disorders;
• the limbs are of different lengths.

How is it carried out?

The traditional ultrasound examination of the hip joint is based on the ability of ultrasonic waves to pass through tissues and reflect off of the surfaces of bones, joints, organs, and fluid cavities. The monitor receives the return signal, which forms an image that the doctor interprets.

The process is carried out on a regular couch. The young one is set on its side. The infant’s pelvic region will be covered by the sensor as the doctor simultaneously bends the legs at the hip joints. Exams are done alternately on both joints.

The process is painless, takes no more than ten to fifteen minutes, and is entirely safe for the child. Parents can relax knowing that there is no scientific or medical data to support the unfounded rumors that ultrasounds cause harm.

It is not deemed appropriate to perform the diagnostic procedure on children younger than 8 months of age. During this time, the femoral head undergoes active ossification, causing areas of darkening and a significant reduction in diagnosis accuracy.

Is preparation necessary?

Before such an ultrasound, parents should only do their best to feed their child. The doctor will be able to get more accurate results during the examination if the baby is more peaceful and still.

It is advised by experts to feed the infant 30 minutes prior to the diagnostic process.

To divert the baby’s attention in the unlikely event that he still chooses to "show character," the mother should also bring along a diaper to cover the office couch with. It should be simple to unbutton and remove the child’s clothing.

A safe, non-invasive method of identifying possible hip joint problems in babies and toddlers early on, such as developmental dysplasia, is hip ultrasound. By ensuring that any issues are identified and addressed right away, this screening promotes healthy growth and prevents further complications.

Decoding

Not just the head of the femur but also the joint positions are evaluated visually. To ascertain their condition, a unique measurement of the angles in accordance with the Graf table is utilized. A beta angle and an alpha angle exist.

• Alpha denotes the development of the bone part of the acetabulum.
• Beta describes the cartilaginous space inside the acetabulum.

If the Beta angle is less than 55 degrees and the Alpha angle is greater than 60 degrees, it is deemed normal for healthy children.

A joint that is slightly over 55 degrees is regarded as normal and mature. However, the physician will conclude that there is a suspicion of dislocation or subluxation if the Beta angle is 77 degrees. Additionally, the Alpha angle, which ranges from 43 degrees to indicates pathology.

This is how the angles in the table are normally arranged.

Angle alpha

Angle beta

Bone outgrowth

In summary

Over 60 degrees

55 degrees or less

Mature, healthy joint

Fits the head of the femur snugly, less than 55 degrees

An immature joint physiologically

Below 55 degrees

Almost flat and round

Below 77 degrees

Over 77 degrees

Smooth or leveled

Under 43 degrees

Does not envelop the head

Decentration and the joint’s total immaturity

During the ultrasound, the doctor will consider the possibility that the indicators will change as the child grows. An X-ray will be the most accurate and correct examination method if the child is four months old already.

When issues are identified, medical professionals attempt to evaluate the pelvic bone structure concurrently. It frequently reflects the pathology of the hip joint.

At the end, the physician might be reticent and just want to give the child’s type of joint an alphanumeric designation. Always keep in mind that a joint in good health is designated as 1A or 1B.

In the event that a 2A or 2B joint is discovered, the child is likely experiencing physiological immaturity, which will likely resolve on its own but still necessitates pediatric orthopedist monitoring.

There are indications of pre-dislocation at joint 2C. A physician’s observation is necessary, as is adherence to all of his recommendations. The joints 3A and 3B are subluxated. Type 4 joints have the most severe pathology. This is the designation for a hip joint that exhibits symptoms of dysplasia, or dislocation.

In conclusion, hip joint ultrasonography is a useful diagnostic technique for evaluating the health of newborns and young children. Early detection of potential issues helps ensure prompt intervention when necessary. Frequent screenings can help parents feel more at ease and protect their child’s development.

Through early detection of issues like hip dysplasia, ultrasound helps medical professionals to prescribe the right courses of action and aftercare. This proactive approach promotes healthier results and enhances the child’s general wellbeing.

In the end, regular hip joint ultrasounds can be extremely important for preserving the comfort and health of your infant. As directed by your pediatrician, maintaining these screenings can have a major impact on your child’s quality of life and future mobility.

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