This book is a reference source containing all the relevant information about Developmental Dysplasia of the Hip (DDH), for people who practice or utilize hip sonography for the early detection and treatment of DDH. It aims at improving the population screening for DDH, thus contributing to the elimination of the disorder and its devastating consequences.
What makes this book different from existing literature is the fact that, apart from the (updated) information about the disorder (including development, pathophysiology, etiology, pathogenesis, risk factors etc.) and a short technical guidance, the reader will find all relevant knowledge to organize training and set up screening. This includes analysis of the rationale behind universal sonographic screening, a comparative presentation of the sonographic techniques, teaching course structure / management and setting up a screening service, including audit, quality control of the scans etc.
Special chapters about radiological diagnosis, imaging the consequences of non-diagnosis or maltreatment of the disorder, clinical management of DDH cases and shaping the future of hip sonography, are also provided.
The book will be of interest to any medical doctor, but in particular to those working in the fields of radiology, pediatrics, orthopedics or general medicine, sonographers performing hip scans, or specialist nurses dealing with DDH.
Author(s): Joseph O'Beirne, Konstantinos Chlapoutakis
Publisher: Springer
Year: 2022
Language: English
Pages: 153
City: Cham
Foreword
Preface
Contents
About the Editors
1: Introduction
References
2: Development of the Hip Joint: Embryology and Anatomy of the Neonatal Hip Joint
2.1 Introduction
2.2 Embryology
2.2.1 Development of the Acetabulum
2.2.2 Development of the Femur
2.3 Anatomy and Postnatal Development of the Hip Joint
2.3.1 Neonatal Acetabulum and Its Postnatal Development
2.3.2 Neonatal Femoral Head and Its Postnatal Development
2.4 Early DDH
2.5 Conclusion
References
3: DDH: Definition, Epidemiology, Pathogenesis, and Risk Factors
3.1 Definition
3.2 Epidemiology
3.3 Pathogenesis
3.4 Risk Factors
References
4: Clinical Examination
4.1 Introduction: Is Clinical Examination in Times of Ultrasound Still Needed?
4.1.1 Historical Background
4.1.2 Principles of Clinical Examination
4.2 How to Examine
4.2.1 Dislocated and Repositionable or Repositioned and Dislocatable (Fig. 4.2a–e)
4.2.2 Stably Dislocated Nonreducible Hip (Fig. 4.3a–d)
4.2.3 Apparent Double Femoral Head and Coxa Vara
4.3 Limitations of Clinical Examination
4.4 Video Content
References
5: An Overview of Diagnostic Imaging Modalities for DDH
5.1 Introduction
5.2 Ultrasonography
5.3 Radiography
5.4 Arthrography
5.5 Computed Tomography (CT)
5.6 Magnetic Resonance Imaging (MRI)
5.7 CT-/MR-Arthrography
5.8 Conclusion
References
6: Imaging of Early-Onset Osteoarthritis
6.1 Introduction
6.2 Pathophysiology and Pathomechanics
6.3 Evaluation of Femoral Head Undercoverage in Adults
6.4 Early Diagnosis of EOA
6.5 Conclusions
References
7: Early Detection of Hip Dysplasia
7.1 Introduction
7.2 Does DDH Merit Screening?
7.3 Defining Early Detection
7.4 Models of Early Detection
7.5 Clinical Surveillance
7.6 Universal US Screening
7.7 Selective US Screening
7.8 Which Model Is More Effective?
7.8.1 Can Late Presentation of DDH Be Prevented by Universal Screening?
7.9 Conclusion
References
8: Freehand Sonographic Techniques
8.1 Introduction
8.2 Hip Stability Assessment—Dynamic Techniques
8.2.1 Harcke’s Dynamic Four-Step Technique
8.2.2 Discussion
8.3 Femoral Head Coverage Methods
8.3.1 Christian Morin
8.3.2 Morin’s Femoral Head Coverage Technique
8.3.3 Terje Terjesen
8.3.4 Bony Rim Percentage Technique (Modified Morin, Terjesen Method)
8.3.5 Lateral Head Distance
8.3.6 Discussion
8.4 Femoral Head Position
8.4.1 Shigeo Suzuki
8.4.2 Suzuki-Femoral Head Position
8.4.3 Discussion
8.5 Ultrasound Acetabular Angle Interrogation
8.5.1 Suzuki
8.5.2 Discussion
8.6 Conclusion
References
9: Hip Sonography According to Graf
9.1 Introduction
9.2 Graf’s Technique: The Basis
9.3 Graf’s Technique: A Stepwise Approach
9.3.1 Baby Positioning - Scanning Technique
9.3.1.1 Step 1: Baby Positioning - Scanning Technique (Including the Selection of Equipment and Image Projection)
9.3.2 Checklist No. 1: Anatomical Identification
9.3.2.1 Step 2: Anatomical Identification
9.3.3 Checklist No. 2: Usability Check
9.3.3.1 Step 3: Usability Check and Tilting Effects
9.3.4 Morphological Classification
9.3.4.1 Step 4: Morphological Classification
9.3.5 Final Classification
9.3.5.1 Step 5: Final Classification
9.4 Strengths of Graf’s Technique
9.5 Keys to a Successful Hip Scan
9.6 Modifications
9.7 Future Developments
9.8 Conclusion
References
10: Comparison of Sonographic Techniques
10.1 Introduction
10.2 Differences Between the Techniques
10.2.1 Anatomical Checklist and Standard Plane
10.2.2 Description, Alpha and Beta Angles Versus Femoral Head Coverage (FHC) and Bony Rim Percentage (BRP)
10.2.3 Dysplasia Vs Immaturity
10.2.4 Instability
10.3 Literature Review
10.3.1 Study Characteristics
10.3.2 Outcome Analysis
10.3.3 Discussion
10.3.4 Summary and Conclusions
References
11: Sonographic-Based Treatment
11.1 Rationale Behind the US-Guided Therapy
11.2 Steps of Therapy
11.2.1 Preparation
11.2.2 Reduction
11.2.3 Retention
11.2.4 Maturation
11.3 Treatment of Late Cases
References
12: Further Treatment
12.1 Introduction
12.2 Arthrography-Assisted Closed Reduction
12.3 Open Reduction
12.4 Future Developments in Reduction Techniques
12.5 Further Treatment of Dysplasia During Growth
12.5.1 Diagnosis and Indications
12.5.2 Treatment Principles
References
13: Clinical Examples
13.1 Introduction
13.2 Sonographic Diagnosis and Treatment of DDH: Hints and Tips
13.3 Conclusion
References
14: Setting Up an Effective Hip Screening Service
14.1 Legal Requirements
14.2 Qualified Examination Staff
14.3 Equipment and Infrastructure Requirements
14.4 Attitude, Philosophy, Education of the Examiner, the Referring Person, and the Parents
14.5 Outcome, Consequences, and Feedback
14.6 Quality Control
References
15: Hip Sonography Training
15.1 Background
15.2 Types of Courses
15.3 Course Content
15.3.1 Basic Course Theory
15.3.2 Resources Required for the Theory Include
15.3.3 Basic Course Scanning Technique
15.3.4 Resources Needed for Teaching Scanning Technique
15.4 Recent Developments in Course Format
15.4.1 Basic Course
15.4.2 Refresher Course
15.5 Course Size
15.6 Social Component
15.7 Faculty
15.8 Participants
15.9 Finance
15.10 Logistics of Running a Course
15.11 Online Teaching
15.12 Post Course Follow-Up
15.13 Certification of Competence
References
16: Hip Sonography: Preparing for the Future
16.1 Introduction
16.2 Diagnosis of DDH—Sonographic Screening
16.3 ICODE
16.4 Preparing for the Future
References
