Hip joint, ultrasound: norm in newborns

Parents are very concerned about newborn children. Any medical appointment causes them a lot of questions. When the doctor directs the baby to check the hip joint, ultrasound seems to be something dangerous and undesirable. However, ultrasound examination has no negative effect on the baby's body. This technique is harmless. Parents should understand that the doctor is called upon to protect their child from serious problems, so his appointment must be carried out. What can alert a doctor and why should she have an ultrasound of the hip joint in the baby?

Indications for ultrasound examination

Children may be born with dysplasia of one or both hip joints. According to statistics, this problem is manifested in 15% of newborns. The first signs of attentive parents notice themselves. Usually they are alarmed by one of the following symptoms:

• One leg of the baby looks shorter than the other;
• When bathing or dressing, it is difficult for the toddler to completely separate the legs, the movement is limited;
• When one or both hips are withdrawn, clicks are heard in the joint;
• Folds on the legs and buttocks are asymmetrical;
• The muscles of the legs are in hypertonia.

However, if the parents did not notice these abnormalities, then the doctor will see them necessarily. He will check mobility and examine the hip joint. Ultrasound will be the best option for clarifying the diagnosis.

Risk group

All babies in 1 and 3 months undergo obligatory medical examination from specialists. However, there is a risk group for hip dysplasia. Particular attention is required for premature babies born at 7-8 months of pregnancy, and children whose mothers had a similar anomaly. In addition, the risk group includes children from multiple pregnancies and those born with pelvic presentation. Ultrasound of the hip joints of newborns from this group can be considered compulsory. Because the earlier the pathology is detected, the greater the chances of completely correcting the situation. Dysplasia of newborns can be cured completely, and in the future the child will not feel any discomfort.

What is dysplasia?

Dysplasia is a congenital disease characterized by underdevelopment or incorrect formation of the hip joint. Medicine distinguishes 3 degrees of the disease:

• I - pre-development of an underdeveloped hip joint with no visible changes in the position of the femoral head with respect to the articular cavity.
• ІІ - subluxation, that is, the hip bone is partially shifted relative to the joint depression.
• ІІІ - dislocation, that is, the head of the hip bone is completely shifted or left from the deepening of the hip joint.

Preparing the baby for ultrasound

How should parents act if a monthly baby needs to examine the hip joint? Ultrasound will be performed in the supine position on the side. The baby during the examination should be calm and motionless. The main task of parents is to ensure a comfortable state of the child so that he can safely transfer the examination.

To the baby was calm, he should be full and healthy. On the day of the examination, it should not be disturbed by colic. 30 minutes before the procedure, the newborn should be fed. If this is done earlier, the baby can get hungry, and if later, then regurgitate during the procedure.

How is ultrasound performed?

Ultrasound of the hip joint in children - the procedure is safe. It does not result in the irradiation of a small patient. The investigations are carried out by a linear scan sensor.

The toddler is placed on a rigid bed, on his side, the legs must be tightened in the hip joints at about an angle of 30 °. In the field of research, a hypoallergenic gel is applied to the skin. The sensor is located above the large trochanter. For clarity of the image, it is shifted to the necessary side. To reveal the decentralization of the joint head, the hips are pulled to the abdomen and rotated. After examining one hip joint, ultrasound is repeated on the other side.

The results of the examination are recorded on thermal paper. After visual examination, the specialist conducts interpretation of the indicators.

Explanation

There are angular indices, which help to decipher the results of the survey. For this, 4 lines are drawn on the ultrasound picture: base, acetabular, inclinational, convective.

Further, angular values are measured and dysplastic changes are evaluated according to the classification list:

• Normal, that is, a full hip joint, is designated as type 1A.
• Transient form of dysplasia, i.e. short with an extended limbus, but without displacements from the center, is designated as type 1B.
• The joint with developmental delay, at which the cartilaginous roof section is widened above the depression, is designated as type 2.
• Joint with delayed formation (for children younger than 3 months) - as type 2A.
• Joint with delayed maturation at the age of over 3 months is type 2B.
• The changes with a slight decentralization are designated as type 2B.
• The joint with a delay in development and a flattened roof of the cavity is designated as type 3.
• Underdevelopment of the joint without structural changes is designated as type 3A.
• Underdevelopment with structural rearrangement of cartilage - type 3B.
• Severe underdevelopment with the exit of the head from the joint cavity - type 4.

After deciphering ultrasound of the hip joints, the development rate or pathology is described and transmitted to the treating doctor. However, if the examination was carried out by a medical professional without appropriate qualification, the sensor could be located in the wrong places. This means that the result will be incorrect.

Are there any contraindications for babies?

Nervous about the appointment of the parents should not be. Ultrasound of the hip joints of newborns, whose age is 1 month, has no contraindications. Starting from 2 months, the ossification of the head of the hip bone can become a contraindication. In this case, starting from the age of three months, an x-ray of the hip joints can be prescribed .

In some cases, the love of children takes a strange character. Parents are afraid that orthopedic constructions (stirrups, struts) cause inconvenience to the baby, and remove them. They think that they have pitied the little man, but the consequence of such "pity" may be disability. The child with age will begin to experience pain, his legs will have different lengths. In time, an operation to replace the joint may be necessary. Is this what the "compassionate" parents wanted for their treasure?