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Pediatrics
Diagnosis
Musculoskeletal
Abnormalities of the Hip
Developmental Hip Dysplasia
Developmental Hip Dysplasia
Hank Baskin, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Pathology

        • Clinical Issues

          TERMINOLOGY

          • Abbreviations

            • Developmental dysplasia of hip (DDH)

          • Synonyms

            • Congenital dislocation of hip (archaic)

          • Definitions

            • Spectrum of progressive hip abnormalities developing during infancy & resulting in acetabular dysplasia with femoral head malpositioning
              • Ranges from mild subluxation → dislocatable hip → fixed hip dislocation
              • Abnormal position of femoral head relative to acetabulum results in abnormal growth of both components of hip

          IMAGING

          • General Features

            • Ultrasonographic Findings

              • Radiographic Findings

                • CT Findings

                  • MR Findings

                    • Nonvascular Interventions

                      • Imaging Recommendations

                        DIFFERENTIAL DIAGNOSIS

                          PATHOLOGY

                          • General Features

                            • Staging, Grading, & Classification

                              CLINICAL ISSUES

                              • Presentation

                                • Demographics

                                  • Natural History & Prognosis

                                    • Treatment

                                      Selected References

                                      1. Fukiage K et al: Femoral head volume indicates the severity of developmental dysplasia of the hip by a method using three-dimensional magnetic resonance imaging. J Pediatr Orthop B. 24(4):286-90, 2015
                                      2. Gornitzky AL et al: Does perfusion MRI after closed reduction of developmental dysplasia of the hip reduce the incidence of avascular necrosis? Clin Orthop Relat Res. 474(5):1153-65, 2015
                                      3. Kotlarsky P et al: Developmental dysplasia of the hip: what has changed in the last 20 years? World J Orthop. 6(11):886-901, 2015
                                      4. LeBa TB et al: Ultrasound for infants at risk for developmental dysplasia of the hip. Orthopedics. 38(8):e722-6, 2015
                                      5. Mace J et al: Neonatal clinical screening of the hip in the diagnosis of developmental dysplasia of the hip: a 15-year prospective longitudinal observational study. Bone Joint J. 97-B(2):265-9, 2015
                                      6. Osborn DA: Independent predictors identified for developmental dysplasia of the hip. J Pediatr. 166(5):1322-3, 2015
                                      7. Tafazal S et al: Do we need to follow up an early normal ultrasound with a later plain radiograph in children with a family history of developmental dysplasia of the hip? Eur J Orthop Surg Traumatol. 25(7):1171-5, 2015
                                      8. Bracken J et al: Ultrasonography in developmental dysplasia of the hip: what have we learned? Pediatr Radiol. 42(12):1418-31, 2012
                                      9. Gould SW et al: Protocol for MRI of the hips after spica cast placement. J Pediatr Orthop. 32(5):504-9, 2012
                                      10. Ortiz-Neira CL et al: A meta-analysis of common risk factors associated with the diagnosis of developmental dysplasia of the hip in newborns. Eur J Radiol. 81(3):e344-51, 2012
                                      11. Azzopardi T et al: Late diagnosis of developmental dysplasia of the hip: an analysis of risk factors. J Pediatr Orthop B. 20(1):1-7, 2011
                                      12. Delaney LR et al: Developmental dysplasia of the hip: background and the utility of ultrasound. Semin Ultrasound CT MR. 32(2):151-6, 2011
                                      13. Laor T: Spica MRI after closed reduction for developmental dysplasia of the hip. Pediatr Radiol. 41(6):790, 2011
                                      14. Pillai A et al: Diagnostic accuracy of static graf technique of ultrasound evaluation of infant hips for developmental dysplasia. Arch Orthop Trauma Surg. 131(1):53-8, 2011
                                      15. Wakabayashi K et al: MRI findings in residual hip dysplasia. J Pediatr Orthop. 31(4):381-7, 2011
                                      16. Walton MJ et al: The success of management with the Pavlik harness for developmental dysplasia of the hip using a United Kingdom screening programme and ultrasound-guided supervision. J Bone Joint Surg Br. 92(7):1013-6, 2010
                                      17. American Institute of Ultrasound in Medicine: AIUM Practice Guideline for the performance of the ultrasound examination for detection of developmental dysplasia of the hip.
                                      18. Domzalski M et al: Avascular necrosis after surgical treatment for development dysplasia of the hip. Int Orthop. 28(2):65-8, 2004
                                      19. Ucar DH et al: Treatment of developmental dysplasia of the hip with Pavlik harness: prospective study in Graf type IIc or more severe hips. J Pediatr Orthop B. 13(2):70-4, 2004
                                      20. Mubarak SJ et al: Pavlik: the man and his method. J Pediatr Orthop. 23(3):342-6, 2003
                                      21. Graf R: Advantages and disadvantages of various access routes in sonographic diagnosis of dysplasia and luxation in the infant hip. J Pediatr Orthop B. 6(4):248-52, 1997
                                      Related Anatomy
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                                      Related Differential Diagnoses
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                                      References
                                      Tables

                                      Tables

                                      KEY FACTS

                                      • Terminology

                                        • Imaging

                                          • Pathology

                                            • Clinical Issues

                                              TERMINOLOGY

                                              • Abbreviations

                                                • Developmental dysplasia of hip (DDH)

                                              • Synonyms

                                                • Congenital dislocation of hip (archaic)

                                              • Definitions

                                                • Spectrum of progressive hip abnormalities developing during infancy & resulting in acetabular dysplasia with femoral head malpositioning
                                                  • Ranges from mild subluxation → dislocatable hip → fixed hip dislocation
                                                  • Abnormal position of femoral head relative to acetabulum results in abnormal growth of both components of hip

                                              IMAGING

                                              • General Features

                                                • Ultrasonographic Findings

                                                  • Radiographic Findings

                                                    • CT Findings

                                                      • MR Findings

                                                        • Nonvascular Interventions

                                                          • Imaging Recommendations

                                                            DIFFERENTIAL DIAGNOSIS

                                                              PATHOLOGY

                                                              • General Features

                                                                • Staging, Grading, & Classification

                                                                  CLINICAL ISSUES

                                                                  • Presentation

                                                                    • Demographics

                                                                      • Natural History & Prognosis

                                                                        • Treatment

                                                                          Selected References

                                                                          1. Fukiage K et al: Femoral head volume indicates the severity of developmental dysplasia of the hip by a method using three-dimensional magnetic resonance imaging. J Pediatr Orthop B. 24(4):286-90, 2015
                                                                          2. Gornitzky AL et al: Does perfusion MRI after closed reduction of developmental dysplasia of the hip reduce the incidence of avascular necrosis? Clin Orthop Relat Res. 474(5):1153-65, 2015
                                                                          3. Kotlarsky P et al: Developmental dysplasia of the hip: what has changed in the last 20 years? World J Orthop. 6(11):886-901, 2015
                                                                          4. LeBa TB et al: Ultrasound for infants at risk for developmental dysplasia of the hip. Orthopedics. 38(8):e722-6, 2015
                                                                          5. Mace J et al: Neonatal clinical screening of the hip in the diagnosis of developmental dysplasia of the hip: a 15-year prospective longitudinal observational study. Bone Joint J. 97-B(2):265-9, 2015
                                                                          6. Osborn DA: Independent predictors identified for developmental dysplasia of the hip. J Pediatr. 166(5):1322-3, 2015
                                                                          7. Tafazal S et al: Do we need to follow up an early normal ultrasound with a later plain radiograph in children with a family history of developmental dysplasia of the hip? Eur J Orthop Surg Traumatol. 25(7):1171-5, 2015
                                                                          8. Bracken J et al: Ultrasonography in developmental dysplasia of the hip: what have we learned? Pediatr Radiol. 42(12):1418-31, 2012
                                                                          9. Gould SW et al: Protocol for MRI of the hips after spica cast placement. J Pediatr Orthop. 32(5):504-9, 2012
                                                                          10. Ortiz-Neira CL et al: A meta-analysis of common risk factors associated with the diagnosis of developmental dysplasia of the hip in newborns. Eur J Radiol. 81(3):e344-51, 2012
                                                                          11. Azzopardi T et al: Late diagnosis of developmental dysplasia of the hip: an analysis of risk factors. J Pediatr Orthop B. 20(1):1-7, 2011
                                                                          12. Delaney LR et al: Developmental dysplasia of the hip: background and the utility of ultrasound. Semin Ultrasound CT MR. 32(2):151-6, 2011
                                                                          13. Laor T: Spica MRI after closed reduction for developmental dysplasia of the hip. Pediatr Radiol. 41(6):790, 2011
                                                                          14. Pillai A et al: Diagnostic accuracy of static graf technique of ultrasound evaluation of infant hips for developmental dysplasia. Arch Orthop Trauma Surg. 131(1):53-8, 2011
                                                                          15. Wakabayashi K et al: MRI findings in residual hip dysplasia. J Pediatr Orthop. 31(4):381-7, 2011
                                                                          16. Walton MJ et al: The success of management with the Pavlik harness for developmental dysplasia of the hip using a United Kingdom screening programme and ultrasound-guided supervision. J Bone Joint Surg Br. 92(7):1013-6, 2010
                                                                          17. American Institute of Ultrasound in Medicine: AIUM Practice Guideline for the performance of the ultrasound examination for detection of developmental dysplasia of the hip.
                                                                          18. Domzalski M et al: Avascular necrosis after surgical treatment for development dysplasia of the hip. Int Orthop. 28(2):65-8, 2004
                                                                          19. Ucar DH et al: Treatment of developmental dysplasia of the hip with Pavlik harness: prospective study in Graf type IIc or more severe hips. J Pediatr Orthop B. 13(2):70-4, 2004
                                                                          20. Mubarak SJ et al: Pavlik: the man and his method. J Pediatr Orthop. 23(3):342-6, 2003
                                                                          21. Graf R: Advantages and disadvantages of various access routes in sonographic diagnosis of dysplasia and luxation in the infant hip. J Pediatr Orthop B. 6(4):248-52, 1997
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