Ultrasound of the hip joints in infants: normal and pathology
Dysplasia often occurs in baby girls, but boys are also vulnerable to dislocation of the hip joint.
Pelvis and hips are connected by two articular surfaces: head from the femur and the acetabulum side of the pelvic bone. In addition to the bone elements of the joint is reinforced by strong intra-articular ligament and multiple extra-articular ligaments, capsule, etc. Directly to the glenoid body 3 is surrounded by powerful muscles that coordinate his work.
This term is understood the inferiority of the joint, as the body. Femur offset in relation to the pelvic. Sometimes disturbed the configuration of the femoral head (lat. caputfemoris) or the acetabulum (lat. the acetabulum), or both articular surfaces. Violation of the skeletal system leads to pathological changes in the ligaments and muscles.
Examination for dysplasia
A competent neonatologist in the delivery room suspect pathology. But to put the diagnosis can only traumatologist.
Normal the child attends podiatrist 4 times during the first year of life:
- 1 month (over 30 days);
- 3 months;
- 6 months;
- 12 months.
If necessary, more often.
The sooner the orthopedist found the problem, the better for the child. Babies moms should take active participation in monitoring, especially if the family has had similar cases.
You should pay attention to mothers of newborn children?
- Skin folds under the buttocks – normal identically symmetrical.
- The length of the legs – both legs of equal length.
- The tone of the lower limbs should not be elevated.
- Abduction of the hip with flexed knee joint – slight movement and no clicks.
If the doctor clinically diagnosed dysplasia, the first step after inspection is to perform an ultrasound. The mother of the child needs in the short term to determine where to do an ultrasound of the hip joints novorozdennogo.
Who else can and should be an ultrasound of the hip joint?
- A premature infant.
- Children from multiple pregnancies.
- If any of the child’s parents suffered in childhood dysplasia.
- If the newborn was not in cephalic presentation (pelvic, lateral, gluteal).
- Children with neurological disorders.
Why infants are advised to do just the ultrasound and not x-rays?
There are several reasons:
- Ultrasound is the least dangerous of instrumental research method, x-rays can cause harm to the fragile child’s organism.
- To carry out the procedure ultrasound of the hip joints in children is easier than x-rays, since it does not need a strong fixing.
- Ultrasound of the hip joints in newborns is the most informative method. Allows you to evaluate the condition of the entire joint, and it is possible to determine the desired angles.
The acetabular angle
The degree of slope vertiujeni of trenches have been termed the acetabular angles or indexes. The angle formed by the line drawn from the proximal edge of the acetabulum to the distal and horizontal line, which is carried out at the bottom of acetabulum. Best assessed on radiographs.
|The hip joint||Configuration
|Bone roof||The alpha angle (∠α)||Betta angle (∠β)||The femoral head alone||The femoral head by provocation|
|The norm||rectangular||horizontal||greater than 60°||less than 55°||centralized||centralized|
|Delayed ossification||rounded||short||43-59°||55-77°||centralized||centralized or laterality|
|Subluxation of the hip||beveled||a little concave||more than 43°||more than 77°||laterality||laterality|
|Hip dislocation||beveled||strongly concave||43°||more than 77°||laterality||laterality|
How do ultrasound
The procedure ultrasound of the hip joints in children is carried out in a special installation. The child lies on his right side and his left leg is bent at a right angle at the hip and knee joint. For examination of the second joint of a newborn turn on the other side.
What to do after the ultrasound
If the ultrasound showed signs of dislocation or subluxation of the hip joint, it is necessary to quickly form the treatment program of the child. If it’s infants, we can restrict wide of the swaddle or the diaper so that the legs in the hip joints was bent and set aside. Still a need for medical gymnastics, physiotherapy and massage. If that’s not enough, the treatment included a special orthopedic techniques.
For older children (1-6 months) used tires retaining the legs in a certain position, forming right angles. Treatment of dysplasia long-term (six months or more). Within a few months the baby’s legs must be in the correct position, for normal formation of the articular surfaces.
If the ultrasound determined that the condition of the hip joints normal newborn and the angles are correct, then there is no dysplasia. But this does not mean that it will not occur. So parents should remain vigilant and if you suspect immediately to seek help for trauma.