Hip Ultrasound in Developmental Hip Dysplasia- An Initial experience at a Tertiary Specialized Teaching Hospital in Addis Ababa, Ethiopia

  • Daniel ZEWDNEH SOLOMON Addis Ababa University



Background: Developmental dysplasia of the hip is a congenitalanomaly. Clinical assessment is not effective and efficient as assumed previously, and the role of ultrasound imaging has increased over time and is now employed for screening of neonates. The local literature lacks information. The purpose of this article is to do a preliminary ultrasound assessment of itsstatusamong infants.

Methods: A cross-sectional study was conducted in the pediatric unit of the Department of Radiology at TikurAnbessa Specialized Teaching Hospital from August 2018- to February 2019.Participants were selected based on recommended age (4-24 weeks) Hipultrasound was performedusing the Graf static method to measure alpha and beta angles of both hips and measurements were grouped according to the Graf classification. Mean values of alpha and beta angles of both hipsidesand types were analyzed. Independent sample T test was used for analysis where appropriate.

Result:Over the specified period, 65 neonates within the age group 4-24 weekswere scanned. 40(61.5%) were males and 25 (38.5%) females.Graf type II (immature and dysplastic) hips comprised 4.61% for the right hip and 10.7% for the left in males and 4.61% each for both hips in females).Type IV(dislocated) hips comprised 4.61% for the right hip and 1.5% for the left in males and was not identified in females.

Conclusion:The proportion of abnormal hips identified in the study warrants the need for a much larger and more comprehensive study and the use of ultrasound for a wider clinical application or a potential screening strategy is recommended.


Key Words: developmental hip dysplasia, Ultrasound, hip angles


Author Biography

Daniel ZEWDNEH SOLOMON, Addis Ababa University










VivekGulati et al: Developmental dysplasia of the hip in the newborn: A systematic review: World Journal of Orthppedics: 2013: 4(2): 32-41

SharyarNoordin et al: Developmental dysplasia of the hip: Orthop Rev (Pavia). 2010; 2(2): e19.

Randal T Loder et al: The epidemiology and demographics of hip dysplasia: ISRN Orthopedics: 2010: Volume 2011: 1-46

C A Lawry et al: Auditing hip ultrasound screening of infants at increased risk of developmental dysplasia of the hip: Arch. Dis Child:2005: 90 (579-581)

Lane B Labore et al: Screening strategies for hip dysplasia: Long term outcomes of a randomized controlled trial: Pediatrics:2013:132(3): 492-501

Bruno de Castro Paixaoet al: Using the Graf method of ultra sound examination to classify hip dysplasia in neonates: Autopsy and Case Reports: 2012: 2(2): 5-10

Vialik B, Berant M: Immunity of Ethiopian Jews to developmental dysplasia of the hips: A preliminary sonographic study: J Pediar. Orthop.B: 1997: 6(4): 253-254

MeghamEmrie, Vanessa Scott: Is ultrasound screening for DDH in babies born breech sufficient: J. Child. Orthop: 2010: 4: 3-8

N M P Clarke, H T Harcke, et al: Real time ultrasound in the diagnosis of congenital dislocation and hip dysplasia of the hip: Bone and Joint Journal: 1985: 67B (3):406-412

P Sharpe et al: Differences in risk factors between early and late diagnosed developmental dysplasia if the hip:Arch. Dis. Child: Neonatal Ed: 2006: 91: 158-162

Graf R. The diagnosis of congenital hi-joint dislocation by the ultrasonic compound treatment. Arch Orthop Trauma Surg. 1980; 97(2):117-33.

Alexiev VA, Harcke HT, Kumar SJ. Residual dysplasia after successful Pavlik harness treatment: early ultrasound predictors. J PediatrOrthop2006; 26: 16-23

Sernik R, Ascencio JEB. Quadril. In: Cerri GG, Sernik R. Ultrassonografiadosistemamusculoesquelético: correlação com ressonânciamagnética. Rio de Janeiro: Revinter; 2009. p. 259-315. Portuguese.

Baronciani D, Atti G, Andiloro F, et al. Screening for developmental dysplasia of the hip: from theory to practice. Pediatrics. 1997;99(2):e5. PMid

Gharedaghi M, Mohammadzadeh A, Zandi B. Comparison of clinical and sonographic prevalence of developmental dysplasia of the hip. Acta Med Iran. 2011;49(1):25-7.

HyengKue Park et al: The utility of ultrasonography for the diagnosis of DDH of the hip joint in congenital muscular torticollis: Ann. Rehabil. Med. 2013: 37(1): 26-32

Martin et al: Developmental dysplasia of the hip (DDH) - Review of major imaging techniques: Educational Exhibit : European Society of Radiology(ESR) : 2017: Poster No: C-2053: DOI: 10.1594/ecr2017/C-2053

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