Skip to main content

Advertisement

SpringerLink
Log in

Diagnostic accuracy of static graf technique of ultrasound evaluation of infant hips for developmental dysplasia

  • Orthopaedic Surgery
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Introduction

Ultrasound examination of infant hips is a widely used and accepted tool for the diagnosis and monitoring of developmental dysplasia of the hip. Its use and timing is still a focus of debate and its diagnostic accuracy has not been fully investigated.

Method

We have compared the ultrasound findings by the Graf technique with radiographic appearance (acetabular index) at 6 months of age.

Result

The negative predictive value of Ultrasound for DDH was 98% and was unaffected by the timing of the examination. The specificity and accuracy of the examination increased with age and was highest at 3 months of age.

Conclusion

Ultrasound examination of the infant hip by the static Graf technique is a safe and effective screening tool for the evaluation of DDH.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Woolacott NF, Puhan MA, Steurer J, Kleignen J (2005) Ultrasonography in the screening for developmental dysplasia of the hip in newborns: systematic review. BMJ 330:1413–1418

    Article  PubMed  Google Scholar 

  2. Graf R (1984) Classification of hip joint dysplasia by means of sonography. Arch Orthop Trauma Surg 102:248–255

    Article  CAS  PubMed  Google Scholar 

  3. Harcke HT, Grisom LE (1990) Performing dynamic sonography of the infant hip. Am J Roentgenol 155:837–844

    CAS  Google Scholar 

  4. Terjesen T, Runden TO, Tangerud A (1989) Ultrasonography and radiography of the hip in infants. Acta Orthop Scand 60:651–660

    Article  CAS  PubMed  Google Scholar 

  5. General Register Office for Scotland. http://www.gro-scotland.gov.uk/

  6. Schwend RM, Schoenecker P, Richards BS, Flynn J, Vitale M (2007) Screening the newborn for DDH: now what do we do? J Paediart Orthop 27(6):607–610

    Google Scholar 

  7. Screening for developmental dysplasia of the hip: recommendation statement. US Preventive Services Task Force. Pediatrics 2006; 117(3):898–902

    Google Scholar 

  8. Macpherson K (2006) Screening hips of newborns in Scotland. A Health Technology Assessment scoping report. NHS Quality Improvement Scotland 2006. http://www.nhshealthquality.org/nhsqis/files/HipHTA_ScopingReport.pdf

  9. Eidelman M, Katzman A, Frieman S (1997) Management of dislocated hips with Pavlik harness treatment and ultrasound monitoring. J Paediat Orthop 17:189–198

    Article  Google Scholar 

  10. Luhmann SJ, Bassett GS, Gordon JE, Schootman M, Schoenecker PL (2003) Reduction of a dislocation of the hip due to developmental dysplasia. Implications for the need for future surgery. J Bone Joint Surg Am 85-A(2):239–243

    PubMed  Google Scholar 

  11. Grill F, Benshel H, Canadell J (1988) The Pavlik harness in the treatment of congenital dislocating hip: report on a multicenter study of the European Paediatric Orthopaedic Society. J Pediatr Orthop 8:1–8

    CAS  PubMed  Google Scholar 

  12. Portinaro NM, Pelillo F, Cerutti P (2007) The role of ultrasonography in the diagnosis of developmental dysplasia of the hip. J Pediatr Orthop 27(2):247–250

    PubMed  Google Scholar 

  13. Baronciani D, Atti G, Andiloro F, Bartesaghi A, Gagliardi L, Passamonti C, Petrone M, Collaborative Group DDH Project (1997) Screening for developmental dysplasia of the hip: from theory to practice. Peadiatrics 99(2):e5

    Article  CAS  Google Scholar 

  14. Laurenson RD (1959) The acetabular index. A critical review. J Bone Joint Surg 41(B):702–710

    Google Scholar 

  15. Koven B, Koven MT (1949) Early dysplasias of the hip. Arch Paediatr 66:201

    CAS  Google Scholar 

  16. Martin HE (1951) Geometrical–Anatomical factors and their significance in the early X ray diagnosis of of hip joint disease in children. Radiology 56:842

    CAS  PubMed  Google Scholar 

  17. Colonna PC (1953) Recognition and treatment of hip dysplasia in the infant. Surg Clin North Am 33:1.633

    Google Scholar 

  18. Nimityongskul P, Hudgens RA, Anderson LD, Melhem RE, Green AE, Saleeb SF (1995) Ultrasonography in the management of developmental dysplasia of the hip. J Pediatr Orthop 15(6):741–746

    CAS  PubMed  Google Scholar 

  19. Hensinger RN (1995) The changing role of ultrasound in the management of developmental dysplasia of the Hip. J Pediatr Orthop 15(6):723–724

    CAS  PubMed  Google Scholar 

  20. Stein-Zamir C, Volovik I, Rishpon S, Sabi R (2008) Developmental dysplasia of the hip: risk markers, clinical screening and outcome. Paediatr Int 50(3):341–345

    Article  Google Scholar 

  21. Tonnis D (1976) Nornal values of the hip jint for the evaluation of X rays in children and adults. Clin Orthop Relat Res 19:39–47

    Google Scholar 

  22. Graf R (1980) The diagnosis of congenital hip-joint dislocation by the ultrasound compound treatment. Arch Orthop Trauma Surg 97:117–133

    Article  CAS  PubMed  Google Scholar 

  23. Committee on Quality Improvement, Subcommittee on Developmental Dysplasia of the Hip. American Academy of Paediatrics (2000) Clinical practice guideline: early detection of developmental dysplasia of the hip. Paediatrics 105(4):896–905

    Article  Google Scholar 

  24. Patel H (2001) Preventive health care, 2001 update: screening and management of developmental dysplasia of the hip in newborns. Can Med Assoc J 164(12):1669–1677

    CAS  Google Scholar 

  25. Elbourne D, Dezteux C, Arthur R, Clarke NM, Gray A, King A, Quinn A, Gardner F, Russell G (2002) Ultrasonography in the diagnosis and management of developmental hip dysplasia (UK Hip Trial): clinical and economic results of a multicentre randomised controlled trial. UK Collaborative Hip Trial Group. Lancet 360(9350):2009–2017

    Article  PubMed  Google Scholar 

  26. Dezteux C, Brown J, Arthur R, Karnon J, Parnaby A (2003) Performance, treatment pathways and effects of alternative policy options for screening for DDH in UK. Arch Dis Child 88:753–759

    Article  Google Scholar 

  27. Roovers EA, Boere-Boonekamp MM, Castelein RM, Zielhuis GA, Kerkhoff TH (2005) Effectiveness of ultrasound screening for developmental dysplasia of the hip. Arch Dis Child Fetal Neonatal Ed 90:F25–F30

    Google Scholar 

  28. Koureas G, Wicart P, Seringe R (2007) Etiology of developmental hip dysplasia or dislocation: review article. Hip Int 17(2 suppl. 5):S1–S8

    PubMed  Google Scholar 

  29. Arumilli BRB, Keneru P, Garg NK, Davies R, Saville S, Sampath J, Bruce C (2006) Is secondary radiological follow-up of infants with a family history of developmental dysplasia of the hip necessary? J Bone Joint Surg 88B(9):1224–1227

    Google Scholar 

  30. Tschauner C, Klapsch W, Baumgartner A, Graf R (1994) Maturation curve of the ultrasonographic alpha angle according to Graf’s untreated hip joint in the first year of life. Z Orthop Ihre Grenzgeb 132(6):502–504

    Article  CAS  PubMed  Google Scholar 

  31. von Kries R, Ihme N, Oberle D, Lorani A, Stark R, Altenhofen L, Niethard FU (2003) Effect of ultrasound screening on the rate of first operative procedures for developmental hip dysplasia in Germany. Lancet 362(9399):1883–1887

    Article  Google Scholar 

  32. Ihme N, Altenhofen L, von Kries R, Niethard FU (2008) Hip ultrasound screening in Germany. Results and comparison with other screening procedures. Orthopade 37(6):541–6, 548–9

    Google Scholar 

  33. Graf R, Tschauner, Klapsch W (1993) Progress in prevention of late DDH by sonographic newborn screening-results of comparative follow up study. J Pead Orthop B, 2:115–21

  34. Schilt M (2001) Optimaler Zeitpunkt des Huftsonographie-Screenings. Ultraschall in Med 22:39–47

    Article  CAS  Google Scholar 

  35. Graf R (2002) Huftsonographie-Ein Update. Orthopade 31:181–189

    Article  CAS  PubMed  Google Scholar 

  36. Portinaro NMA, Murray DW, Bhullar TPS, Benson MKD (1995) Errors in measurement of Acetabular index. J Pead Orthop 15:780–784

    CAS  Google Scholar 

  37. Spatz D, Reiger M, Klaumann M, Miller F, Stanton R, Lipton G (1997) Measurement of acetabular index. Intraobserver and Interobserver variation. J Paediatr Orthop 17(2):174–175

    CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Glasgow Royal Infirmary, Glasgow, G4 0SF, Scotland, UK

    Anand Pillai

  2. Victoria Infirmary, Glasgow, G42 9TY, Scotland, UK

    Jibu Joseph

  3. Statistics Department, NHS Lanarkshire, Airbles Hospital, Motherwell, ML1 2TP, Scotland, UK

    Andrew McAuley

  4. Monklands Hospital, Airdrie, ML6 0JS, Scotland, UK

    Diane Bramley

  5. 3/2. 63Avenuepark street, Glasgow, G20 8LN, Scotland, UK

    Anand Pillai

Authors
  1. Anand Pillai
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Jibu Joseph
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Andrew McAuley
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Diane Bramley
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Anand Pillai.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Pillai, A., Joseph, J., McAuley, A. et al. Diagnostic accuracy of static graf technique of ultrasound evaluation of infant hips for developmental dysplasia. Arch Orthop Trauma Surg 131, 53–58 (2011). https://doi.org/10.1007/s00402-010-1100-9

Download citation

  • Received:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00402-010-1100-9

Keywords

Search

Navigation