• acetabulum
• comparative
• hip dysplasia
• one health
• translational
• treatment

Developmental dysplasia of the hip comprises a broad spectrum of abnormalities in hip development, of variable severity. Besides physical examination, ultrasound is the preferred imaging modality for screening for developmental dysplasia of the hip in children aged younger than six months. The Graf method is the most widely used ultrasound technique for infant hips; a stepwise approach will be shown in this article. Furthermore, the process of dynamic ultrasound imaging will be explained as well as the use of transinguinal ultrasound in infants wearing a spica cast. There is no consensus on the best way to screen for developmental dysplasia of the hip, which is probably the reason why different screening programs exist throughout Europe, as will be discussed in this article. The use of universal versus selective ultrasound remains a controversy, as does the timing. Is it better to perform sonography in all newborn infants like in Germany and Austria? Or should we examine only the infants with clinical hip instability or risk factors (breech position, positive family history), like in the UK and the Netherlands? This article reviews the epidemiology, static and dynamic ultrasound techniques in screening for developmental dysplasia of the hip, and differences in screening programs throughout Europe. Set aside the uncertainties about whom and when to screen, it needs to be emphasized that ultrasound screening for developmental dysplasia of the hip is important, since the disease is initially occult and easier to treat when identified early. In this way, the radiologist can aid in preventing serious disability of the hip.

• DDH
• hip
• pediatric
• screening
• ultrasound

Developmental dysplasia of the hip (DDH) describes the spectrum of structural abnormalities that involve the growing hip. Early diagnosis and treatment is critical to provide the best possible functional outcome. Persistence of hip dysplasia into adolescence and adulthood may result in abnormal gait, decreased strength and increased rate of degenerative hip and knee joint disease. Despite efforts to recognize and treat all cases of DDH soon after birth, diagnosis is delayed in some children, and outcomes deteriorate with increasing delay of presentation. Different screening programs for DDH were implicated. The suspicion is raised based on a physical examination soon after birth. Radiography and ultrasonography are used to confirm the diagnosis. The role of other imaging modalities, such as magnetic resonance imaging, is still undetermined; however, extensive research is underway on this subject. Treatment depends on the age of the patient and the reducibility of the hip joint. At an early age and up to 6 mo, the main treatment is an abduction brace like the Pavlik harness. If this fails, closed reduction and spica casting is usually done. After the age of 18 mo, treatment usually consists of open reduction and hip reconstruction surgery. Various treatment protocols have been proposed. We summarize the current practice for detection and treatment of DDH, emphasizing updates in screening and treatment during the last two decades.

• Developmental dysplasia
• Newborn
• Infant
• Children
• Hip
• Developmental dysplasia of the hip

• developmental dysplasia of the hip (ddh)
• treatment
• walking
• age