An echocardiographic examination of newborn hip joints is screening to determine if the hips are normally developed. One of the very common problems of the hip which can occur during the formation of the joint before, during and after birth is developmental hip dysplasia. This means that the development of the articular surfaces is not adequate, the thigh bone does not lie properly in the cup and the joint is unstable, or in more extreme cases partial or complete dislocation of the head from the joint (swollen hip) is present. Failure to recognize and treat this condition in a timely manner can lead to serious consequences for the hip joints. Developmental hip dysplasia occurs in 1-3 of 1000 newborns, and is more common in infants with a family history of the disease, female children, firstborns, babies born in a pelvic position and infants of pregnancies with oligohydramnios present (reduced amount of water) , as well as twin pregnancy.
An echocardiographic examination of the hip is a quick, simple, safe and painless method of visualizing hip joints. In our institution, the world-renowned Graf method uses standardized technique and precisely numbered hip separation system to evaluate the development of hip neonatal development. According to the Graf method there are four types of hips, of which only type I represents a mature and normally developed hip, while types II, III and IV relate to different degrees of hip dysplasia and these hips should be treated.
It is important to know that the success of treatment for hip dysplasia depends on how early it begins – if treated as early as the first few months after birth until the final cure comes in a much simpler noninvasive and shorter way, and the treatment ends with final healing, while treatment at a later age is more complex, encompasses more invasive methods including surgical treatment and leaves the possibility of further consequences on the joint throughout life. It is therefore crucial the first ultrasonographic examination of the hips to make recommendation on time is that it be 40 days after giving birth to all infants, and those with a family history of the disease or clinical diagnosis of unstable hip after birth even during the first seven days of life.