Ultrasound examination of the hip joints in newborns and infants is a fairly accurate method to establish certain anomalies in the development of the musculoskeletal system at a very early age.
Pathologies can be different, but they all have one thing in common: the sooner you can find them and start treatment, the more favorable the prognosis for the baby's health. We will tell you about what such an ultrasound shows, who is assigned and what are the norms in this article.
About diagnostics
Ultrasound of the hip joint (hip joints) is included in the first screening, which is carried out for children aged 1 month. This research is conducted for children free of charge. At any age, such a diagnostic examination can be prescribed by an orthopedic specialist if he suspects certain abnormalities in the development of the joints during a visual examination of the child.
Such a study using ultrasound allows you to assess the condition of the joints, their position, size. Subluxation of the hip joint and pre-dislocation occur most often at an early age. Full dislocation is less common. All of these stages are easily diagnosed with a painless, non-invasive ultrasound examination procedure.
With dysplasia of the hip joint, the doctor will be able to accurately determine the severity of the pathology, which is necessary to prescribe an accurate treatment regimen. The danger of refusal from the planned screening ultrasound of the hip joints lies in the fact that the existing pathology can go unnoticed for a long time. Untimely treatment or its complete absence can lead to very serious consequences: lameness, movement disorders, disability.
The Russian Ministry of Health recommends the study for all infants. But they especially need it:
- premature babies;
- children whose family has relatives with joint pathologies;
- children who were in breech presentation during pregnancy;
- babies who were carried and given birth in large cities, in territories with an unfavorable environmental situation;
- babies born from pregnancy, accompanied by oligohydramnios, severe toxicosis, vitamin deficiency and anemia.
As for the targeted direction for such an examination, it is most often given in the presence of the following symptoms:
- the skin folds on the legs of the newborn are not symmetrical;
- breeding the baby's thighs is difficult, limited;
- the joints when moving the legs create a crunch or click;
- the child's legs are not just in good shape, the doctor qualifies it as hypertonicity;
- the child was not born alone - he is one of twins or triplets;
- the baby has a birth injury, neurological disorders;
- limbs have different lengths.
How is it done?
TBS ultrasound is a classic ultrasound study based on the properties of ultrasonic waves to penetrate tissues, reflect from the surface of organs, joints, bones, fluid cavities. The return signal goes to the monitor and forms an image, which the doctor decrypts.
The procedure is carried out on a standard couch. The child is laid on its side. The doctor will bend the legs at the hip joints while applying the sensor to the baby's pelvic area. Both joints are examined alternately.
The procedure takes no more than 10-15 minutes, it is painless and completely safe for the child. Parents need not worry: the harmful effects of ultrasound are nothing more than speculation, not confirmed by science and medical statistics.
For children aged 2-8 months, a diagnostic procedure is not considered appropriate. It is during this period that active ossification of the femoral head occurs, areas of darkening appear, and therefore the diagnosis loses a solid percentage of accuracy.
Do you need preparation?
The only thing that parents should do before such an ultrasound is to feed the child as best as possible. The more motionless and calm the baby is on the examination, the more accurate the results the doctor will be able to obtain.
Experts recommend feeding the child half an hour before the diagnostic procedure.
Also, mom needs to take with her a diaper, with which she will cover the couch in the office, a dummy and a rattle, in order to distract the baby's attention in case he still decides to "show character." The child's clothes should be easy to open and take off.
Decoding
The position of the joints and the femoral head is assessed not only visually. To determine their condition, a special measurement of angles is used according to the Graph table. There is an Alpha corner and a Beta corner.
- Alpha denotes the development of the bony part of the vein fossa.
- Beta describes the cartilaginous space within the acetabulum.
For healthy children, it is considered normal if the Alpha angle is more than 60 degrees and the Beta angle is less than 55 degrees.
A slight excess of 55 degrees is permissible, such a joint is considered normal, mature. But if the Beta angle is 77 degrees, the doctor will suspect a dislocation or subluxation in the conclusion. Also, the pathology is indicated by the Alpha angle, which ranges from 43 degrees.
The standard of angles in the table is as follows.
During the growth of the child, the indicators may change, this is what the doctor will take into account during the ultrasound scan. If the child is already four months old, an X-ray will be the most correct and accurate examination method.
If problems are found, doctors try to simultaneously examine the bone structure of the small pelvis. Quite often, the pathology of the hip joint is reflected in it.
In conclusion, the doctor may be laconic and would prefer to limit himself to an alphanumeric designation of the type of joint found in the child. Remember that a healthy joint is always labeled 1A or 1B.
If the conclusion indicates that a 2A or 2B joint was found, this means that the child has signs of physiological immaturity, which will go away on its own with great probability, but still require observation by a pediatric orthopedist.
Joint 2C is a joint with signs of pre-dislocation. Observation by a doctor and the implementation of all his recommendations are imperative. 3A and 3B are joints with subluxation. The most severe pathology is type 4 joint. This is how the hip joint with signs of dislocation (dysplasia) is indicated.
General recommendations
Many mothers who are faced with diagnoses such as immaturity of the hip joints in a newborn, note that there should be no reason for panic. In the vast majority of cases, only a systematic visit to the orthopedist is required for control. The joints mature on their own.
Most mothers note that the massage prescribed by the doctor, special therapeutic exercises and calcium preparations helped to cope with the problem identified on the ultrasound at an early age. Mothers try to give it to infants with breast milk, that is, they increase the dose of calcium in their own diet, and begin to take calcium supplements on purpose.
Children are recommended to swaddle wide, wearing diapers one size larger than required, so that the legs are more often in a divorced state.
Parents often note that ultrasound of hip joint is closely related to such a phenomenon as overdiagnosis: doctors quite often “play it safe”, discovering physiological immaturity of joints in almost every second child during the diagnosis during screening.
For more information on the method of ultrasound of the hip joints for newborns and infants, see the following video.
