Diagnosis

The diagnosis of hip luxation is usually made early in the baby’s life, as the hip is routinely examined as part of the preventive medical check-ups (U-examinations). A hip luxation in the baby is relatively clearly indicated by a shortened leg and a number of other unspecific clinical signs, so that the diagnosis is based on the clinic. However, since this is not sufficient to make a diagnosis of hip luxation or hip dysplasia in the baby, the diagnosis is objectified by ultrasound.

In this way, it is also possible to detect changes in the hip that promote hip dislocation in the baby without this having already occurred. As a standard procedure, the hip is ultrasounded for hip luxation in the 4th – 5th week of life as part of the U3 preventive examination. According to Graf, the position of the femoral head in relation to the joint roof of the hip is divided into 4 stages: 1: normally developed hip; 2: delayed maturation (dysplasia); 3: decentered joints (subluxation); 4: complete luxation.

These examinations are sufficient to make a diagnosis of hip luxation in the baby and to initiate appropriate therapy based on the severity of the dislocation. If the diagnosis is made after the 1st year of life, X-rays are also used to better visualize bony parts. Fortunately, hip sonography in children is standard and mandatory in preventive medical checkups in Germany.

Sometimes this is due to the frequency of this malposition, but also to the high benefit that is achieved if the diagnosis and therapy are carried out as early as possible. If possible, the first ultrasound examination is performed after birth. However, this is obligatory at least for U3 screening in the 4th-5th week.

During the first year of life, the bone structure still allows a good assessment of the structures in sonography. Advantages of the examination are no exposure to X-rays, the dynamics during the examination and availability in most medical practices. According to Graf’s examination technique, the angle of the acetabular roof, the cartilage roof and the position of the femoral head are examined.