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Hip sonography screening - the basis for early developmental dysplasia detection and successful treatment

Miroslav Raykov, Milena Avdzhiyska, Georgi Raykov, Konstantin Ganchev, Preslav Penev


Introduction: Developmental dysplasia of the hip (DDH) is a wide spectrum of anomalies, ranging from simple instability with laxity of the articulation capsule to total dislocation of the femoral head from the acetabular socket. The development of the baby in the first months is very fast and the early diagnosis and the appropriate treatment is important for the successful outcome of the disease.

Materials and Methods: Several infantile hip ultrasonography methods have been defined to assess the relationship between the femoral head and acetabulum. The method of Graf is the one that was defined first and is perhaps the most widely used. Reinhard Graf from Stolzalpe, Austria developed his technique in the late 1970s. The primary advantage of this method is that it has a standardised ex­amination technique, as well as a very well defined numeric hip typing system. It divides the joint in 4 types which correlate with the pathological changes. The ultrasound typing is based on a description of important elements of the acetabulum and measurement of two angles which quantify the bony ac­etabular roof and the cartilaginous acetabular roof. Throughout the years, a number of studies have shown the efficiency of the method of Graf in reducing the rate of late DDH and invalidity.

Results: The study present the results of the screening and early treatment of DDH in the Department of Orthopaedics and traumatology - Medical University of Varna. The operative activity of this dis­ease has decreased substantially - from 2-3 per month in the late 90s, to 2-3 per year today.

Conclusion: Early diagnosis and regular examinations lead to better and more effective treatment - by means of abduction gymnastics, abduction pants, and Pavlik harness. Thus the successful treat­ment of DDH depends on an early accurate diagnosis and an earlier start of the treatment.


hip; sonography; DDH; screening; baby



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