Hip Ultrasound

Developmental Dysplasia of the hip affects a significant number of children in the UK. The exact incidence is unknown and difficult to quantify as it is a term given to describe a spectrum of disease that can range from complete dislocation of the hip to some shallowness of the socket of the hip joint. If it is missed then the child will have an increasing risk of lifelong hip problems, usually requiring hip replacement at a young age.

There are several clinical screening tests in place to try and pick this problem up as quickly as possible. They include a post-natal examination of the hips before leaving hospital, a 6 or 8 week examination by the GP .
Unfortunately, these tests are not sensitive. They are difficult tests to perform in a young baby and they are frequently performed by inexperienced personnel. The examination may detect an unstable hip in experienced hands, but will not pick up the more subtle problems such as a shallow hip socket, which can lead to a complete dislocation.

Hip ultrasound is the gold standard for detecting hip problems in children less than 4 months of age. It is a quick, safe and reproducible test, which is well proven. It is a compulsory test for all babies in most European countries and consequently, their rate of late hip dislocation is negligible. The Department of Health in the UK has refused to institute this screening test, which means that we continue to see children with missed dislocations on a regular basis.

Although it is possible to treat these children, it usually means extensive surgery and the hip is rarely back to normal afterwards. The later in the child’s life the problem is detected, the worse the long term outcome.
Mr Thomas is trained in performing ultrasound of the baby hip and is able to offer this service to all babies less than 4 months of age. There are several risk factors for this condition which are listed below:

  1. Family history – any relative or sibling who has had a previous childhood hip problem
  2. Breech position of the child during pregnancy
  3. Oligohydramnios (low level of fluid in the womb during pregnancy)
  4. Foot abnormalities at birth
  5. First born, female sex.

Baby Hip Ultrasound was pioneered by Dr Reinhard Graf, an Austrian orthopaedic surgeon. Mr Thomas has been trained by Dr Graf and is now running the Graf ultrasound course in Cardiff with his colleagues Sandeep Hemmadi and Clare Carpenter. Dr Graf still attends to lead the course.