The main mistakes in sonographic examination of hip joints in infants under one year of age

Wiad Lek. 2019 Oct 31;72(10):1953-1956.

Abstract

Introduction: Developmental dysplasia of hip (DDH) remains one of the most common and severe congenital pathologies in infants. The best results of DDH treatment are observed in early-infancy up to 3 months. A sonographic examination was long recognized as a “golden standard” of early diagnosis of hip dysplasia, but some practitioners still do not trust this method through a certain number of pseudo-positive and pseudo-negative diagnoses. The aim: To carry out the quality analysis of sonographic examination of hip joints in infants under one year of age, to identify the main mistakes during the diagnosis and the causes of their occurrence; determine the dependence of the number of errors on the age of the examined child; suggest a method for assessing the quality of the received sonograms during the survey to reduce the number of false results.

Material and methods: The sonographic images of the hip joints of 782 infants (1564 sonograms in total) aged 0.1–12 months were analyzed, who had been examined in Ortoclinic on the basis of Ternopil Town Clinical Hospital of Emergency Medical Care from 2016 to 2019. The ultrasound examination was performed according to a standard R. Graf technique.The comprehensive evaluation of each sonogram included the following parameters: a clear visualization of all the anatomical structures of the hip joint, the correctness of mutual spatial arrangement of the joint elements, the correct sonographic marking.

Results and conclusions: 498 low-grade sonograms (31,84 %) were identified, which make impossible to objectively assess the degree of development of the joint. The basic causes of errors were found out – incorrect examination and incorrect estimation of the image. The use of special patterns was suggested, which helps to check the quality of the received image at once during the examination and to adjust it according to the standards.

Keywords: hip joint; sonographic examination; errors.

MeSH terms

  • Early Diagnosis
  • Emergency Medical Services*
  • Hip Dislocation, Congenital*
  • Hip Joint / diagnostic imaging*
  • Humans
  • Infant
  • Infant, Newborn
  • Ultrasonography