Orthopedic Disorder Clinical Trial
Official title:
Incidence of Developmental Hip Dysplasia by Ultrasonographic Screening of Asymptomatic Infants Less Than 6 Months Old at Assiut University Hospital Outpatient Clinics
Developmental dysplasia of the hip (DDH), formerly known as congenital dislocation of the hip, comprises a spectrum of abnormalities that include abnormal acetabular shape (dysplasia) and malposition of the femoral head.
The origin and pathogenesis of DDH are multifactorial. Abnormal laxity of the ligaments and
hip capsule is seen in patients with DDH. The maternal hormone relaxin may also be a factor.
Extreme hip flexion with knee extension, as in the breech position, tends to promote femoral
head dislocation and leads to the shortening and contracture of the iliopsoas muscle.
It was previously reported that DDH was the underlying aetiology in about 25 % of the
performed hip replacements under the age of 40 years and the initial diagnosis age ranged
from 0 to 39 years, with a mean of 8 years in these patients.
The main purpose of a newborn hip screening program is to detect DDH as early as possible, so
that early treatment can be given and the need for surgical treatment as well as the
development of residual hip dysplasia can be avoided.
Ultrasonography offers distinct advantages compared with other imaging techniques: unlike
plain radiography, it can distinguish the cartilaginous components of the acetabulum and the
femoral head from other soft tissue structures, real-time US permits multiplanar examinations
that can early determine the position of the femoral head in respect to the acetabulum; thus
it provides the same type of information that can be obtained with arthrography, computerized
tomography, or magnetic resonance imaging, but at lower cost, although ultrasonography is
more expensive than plain radiography, it doesn't require sedation and doesn't involve
ionizing radiation, unlike other techniques and it allows observation of changes in hip
position with movement.
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