Ultrasound of a child's hips in Krakow - Price: PLN 150
Hip ultrasound is a method of screening for hip dysplasia in infants. Dysplasia is a deformation of the femoral head and / or the acetabulum so that the hip joint does not develop properly. If the articular surfaces (head and acetabulum) do not fit together, subluxation or dislocation of the joint may occur. Ultrasound of hip joints in infants allows for early detection of abnormalities and quick implementation of appropriate treatment.
In school-age children, ultrasound of the hip joints enables the detection of other hip pathologies, such as: Perthes' disease, juvenile desquamation of the femoral head, purulent arthritis or transient synovitis. Using ultrasound can also diagnose post-traumatic conditions of the joint and soft tissues of the hip area. Many pediatric ultrasound algorithms have been developed, which allow for the accurate diagnosis correlating with clinical symptoms. When in doubt, your doctor may order an MRI of the hip to assess the internal structures of the joint more accurately.
The long-term effects of untreated or too late diagnosed pathology of the hip joint in children is accelerated development of degenerative changes in the hip (coxartosis) in adulthood.
Make an appointment now - to the doctor who performs ultrasound of the baby's hips in our hospital
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When is ultrasound of hip joints performed in children?
Screening of ultrasound examinations in infants for hip dysplasia is performed twice - between 4 and 6 weeks and between 12 and 14 weeks of age.
In school-age children, painful symptoms in the area of the groin, often radiating towards the thigh, are disturbing symptoms indicative of hip pathologies. Hip pain may be associated with limitation of the range of motion, avoidance of stress on the affected joint manifested by walking limp, and periodic low-grade fever. Moreover, overload knee pain is a disturbing symptom, which may result from wrong positioning of the hip and secondary disturbance of the biomechanics of the lower limb. In any case, consultation with a pediatric orthopedist is recommended.
How is ultrasound of hip joints in children?
Before ultrasound examination of the hips in infants, the doctor performs clinical tests to assess the stability of the hip joints. An example of a test is the Ortolani test, which involves passive external rotation and abduction of bent hips. If, during this movement, there is a perceptible and audible jump in the hip, the doctor may initially conclude that the hip joint is abnormal.
Ultrasound of hip joints does not require special preparation. The examination is completely painless and safe for the child. The doctor places the transducer around the child's hip after applying a small amount of coupling gel to obtain the best image quality.
The doctor assesses the femoral head cover, i.e. the degree of depression of the femoral head in the acetabulum. It then provokes a subluxation in the joint, assessing its stability.
Moreover, ultrasound of the hip joint in children allows to identify disturbances in the structure of the hip joint in the course of other diseases, e.g. aseptic necrosis of the femoral head. The ultrasound examination also reveals any inflammatory exudate and the presence of free bodies in the joint cavity.
Hip diseases and pathologies diagnosed during ultrasound of hips in children
Hip dysplasia
In the late stage of pregnancy or during childbirth, deformation of the articular surfaces of the previously properly developing hip may occur. As a result, the head of the femur can move beyond the acetabulum (joint dislocation).
The etiology of developmental hip dysplasia is most often multifactorial. The risk of developing hip dysplasia is greater in:
children with a family history of abnormalities in the construction of the hip joint,
children with pathological pregnancy (oligohydramnios, mother's hormonal disorders affecting the processes of collagen formation),
children born by buttock delivery,
newborns from twin pregnancy,
premature babies - born before 37 weeks of gestation.
Quick diagnosis of dysplasia and adjustment of the dislocated hip joint allows for further proper development of the hip. If this pathology is omitted, secondary structural changes may occur that make it impossible to adjust and align the joint - the acetabulum gradually becomes shallower, the joint cavity becomes filled with fibrous and fatty tissue, and the joint capsule and ligaments become overstretched.
Early management is essential to avoid complications of hip dysplasia. Slight abnormalities in the structure of the hips are an indication for a wide diaper of the baby. If necessary, the doctor may recommend the use of special orthopedic equipment - Pavlik harness or Frejka pillow, which position the child's lower limbs in the position of flexion, abduction and external rotation. This allows for the centralization of the femoral head and its correct immersion in the hip joint socket. Too late implementation of conservative treatment may lead to the need for surgical treatment.
Perthes disease
Perthes disease is a sterile necrosis of the femoral head, i.e. a disease involving the death of bone tissue. The disease leads to a secondary deformation of the femoral head, threatening its alignment with the acetabulum of the hip joint. It is proposed that the cause of the disease is a disturbed vascularization within the proximal femoral epiphysis. This condition may occur under conditions of increased pressure in the joint cavity or in the presence of coagulation disorders. Necrosis of the femoral head can occur as a result of trauma, but it is often not possible to identify a tangible cause that could lead to necrosis.
Perthes disease has the following stages:
bone ischemia and state of necrosis,
bone fragmentation and resorption,
re-ossification,
remodeling of bone tissue.
The first three stages are characterized by a particularly reduced bone resistance to mechanical stimuli - uncontrolled loading of the hip with body weight may cause flattening and permanent loss of the spherical shape of the femoral head. It is very important to recognize the disease early and relieve the joint in order to minimize deformation and create biomechanical conditions for remodeling bone tissue.
The disease mainly affects boys between the ages of 3-12. Symptoms of aseptic necrosis of the femoral head are pain in the groin that increases during physical activity. Additionally, there is a limitation in the range of motion in the hip joint, which mainly concerns internal rotation and Abduction.
Ultrasound examination is one of the diagnostic methods enabling the diagnosis of lesions typical of the subsequent stages of sterile bone necrosis. Ultrasound is used to monitor disease progression until the end of bone remodeling. For example, an ultrasound examination reveals an irregular, fragmented outline of the proximal femoral epiphysis. The examination also allows to detect the newly formed bone tissue earlier than the X-ray images, and the Doppler method with the administration of a contrast agent enables the location of the revascularization of the femoral head.
Exfoliation of the femoral head
Shedding of the femoral head is a type of damage to the growth cartilage. This may be accompanied by periosteal rupture and secondary bone and joint inflammation. The damage occurs in adolescence, when the cartilaginous growth zone is weakened. The risk factors are mechanical overload (sports activity, overweight) and anatomical predispositions (too deep the acetabulum of the hip joint, reduced angle of the femoral neck anterior inclination). Symptoms of exfoliation of the femoral head are hip pain in the groin area or knee pain associated with the change in the position of the lower limb during walking.
In an ultrasound examination, the degree of exfoliation can be assessed by measuring the fault between the epiphysis and the exfoliated epiphysis. In the acute phase of joint disease, fluid is sometimes found in the anterior recess. However, the initial diagnosis of exfoliation of the femoral head in ultrasound requires X-ray confirmation. Sometimes it is necessary to do an MRI of the hip.
At the Dworska Hospital in Krakow, we also perform ultrasound of the hip joint in adults.
Source:
Martinoli C, Valle M. Zastosowanie USG u dzieci [w:] Derchi L, Rizatto G, Valle M, Zamorani M. Ultrasonografia układu mięśniowo-szkieletowego, Medipage, Warszawa 2009, s. 919-958.
Frequently asked questions about ultrasound of baby hips:
Ultrasound of hip joints in children is a screening test that allows you to assess whether a child's hips are developing properly. An ultrasound scan is performed on a baby between 4 and 6 weeks of age. The second control date of the study is the period of 12-14 weeks of age.
Ultrasound of hip joints in children can detect abnormalities in the structure of pathological changes in the course of diseases such as: hip dysplasia, desquamation of the femoral head, Perthes disease (sterile femoral head necrosis).
Ultrasound of hip joints does not require special preparation. The examination is completely painless and safe for the child. The doctor places the transducer around the child's hip after applying a small amount of coupling gel to obtain the best image quality. The examination takes approximately 20 minutes.
