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Normal variation of infant hip development: patterns revealed by 3D ultrasound

AIMS: Studies of infant hip development to date have been limited by considering only the changes in appearance of a single ultrasound slice (Graf’s standard plane). We used 3D ultrasound (3DUS) to establish maturation curves of normal infant hip development, quantifying variation by age, sex, side,...

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Autores principales: Hareendranathan, Abhilash R., Wichuk, Stephanie, Punithakumar, Kumaradevan, Dulai, Sukhdeep, Jaremko, Jacob
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The British Editorial Society of Bone & Joint Surgery 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9709493/
https://www.ncbi.nlm.nih.gov/pubmed/36440537
http://dx.doi.org/10.1302/2633-1462.311.BJO-2022-0081.R1
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author Hareendranathan, Abhilash R.
Wichuk, Stephanie
Punithakumar, Kumaradevan
Dulai, Sukhdeep
Jaremko, Jacob
author_facet Hareendranathan, Abhilash R.
Wichuk, Stephanie
Punithakumar, Kumaradevan
Dulai, Sukhdeep
Jaremko, Jacob
author_sort Hareendranathan, Abhilash R.
collection PubMed
description AIMS: Studies of infant hip development to date have been limited by considering only the changes in appearance of a single ultrasound slice (Graf’s standard plane). We used 3D ultrasound (3DUS) to establish maturation curves of normal infant hip development, quantifying variation by age, sex, side, and anteroposterior location in the hip. METHODS: We analyzed 3DUS scans of 519 infants (mean age 64 days (6 to 111 days)) presenting at a tertiary children’s hospital for suspicion of developmental dysplasia of the hip (DDH). Hips that did not require ultrasound follow-up or treatment were classified as ‘typically developing’. We calculated traditional DDH indices like α angle (α(SP)), femoral head coverage (FHC(SP)), and several novel indices from 3DUS like the acetabular contact angle (ACA) and osculating circle radius (OCR) using custom software. RESULTS: α angle, FHC, and ACA indices increased and OCR decreased significantly by age in the first four months, mean α(SP) rose from 62.2° (SD 5.7°) to 67.3° (SD 5.2°) (p < 0.001) in one- to eight- and nine- to 16-week-old infants, respectively. Mean α(SP) and mean FHC(SP) were significantly, but only slightly, lower in females than in males. There was no statistically significant difference in DDH indices observed between left and right hip. All 3DUS indices varied significantly between anterior and posterior section of the hip. Mean 3D indices of α angle and FHC were significantly lower anteriorly than posteriorly: α(Ant) = 58.2° (SD 6.1°), α(Post) = 63.8° (SD 6.3°) (p < 0.001), FHC(Ant) = 43.0 (SD 7.4), and FHC(Post) = 55.4° (SD 11.2°) (p < 0.001). Acetabular rounding measured byOCR indices was significantly greater in the anterior section of the hip (p < 0.001). CONCLUSION: We used 3DUS to show that hip shape and normal growth pattern vary significantly between anterior and posterior regions, by magnitudes similar to age-related changes. This highlights the need for careful selection of the Graf plane during 2D ultrasound examination. Whole-joint evaluation by obtaining either 3DUS or manual ‘sweep’ video images provides more comprehensive DDH assessment. Cite this article: Bone Jt Open 2022;3(11):913–923.
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spelling pubmed-97094932022-12-08 Normal variation of infant hip development: patterns revealed by 3D ultrasound Hareendranathan, Abhilash R. Wichuk, Stephanie Punithakumar, Kumaradevan Dulai, Sukhdeep Jaremko, Jacob Bone Jt Open Children’s Orthopaedics AIMS: Studies of infant hip development to date have been limited by considering only the changes in appearance of a single ultrasound slice (Graf’s standard plane). We used 3D ultrasound (3DUS) to establish maturation curves of normal infant hip development, quantifying variation by age, sex, side, and anteroposterior location in the hip. METHODS: We analyzed 3DUS scans of 519 infants (mean age 64 days (6 to 111 days)) presenting at a tertiary children’s hospital for suspicion of developmental dysplasia of the hip (DDH). Hips that did not require ultrasound follow-up or treatment were classified as ‘typically developing’. We calculated traditional DDH indices like α angle (α(SP)), femoral head coverage (FHC(SP)), and several novel indices from 3DUS like the acetabular contact angle (ACA) and osculating circle radius (OCR) using custom software. RESULTS: α angle, FHC, and ACA indices increased and OCR decreased significantly by age in the first four months, mean α(SP) rose from 62.2° (SD 5.7°) to 67.3° (SD 5.2°) (p < 0.001) in one- to eight- and nine- to 16-week-old infants, respectively. Mean α(SP) and mean FHC(SP) were significantly, but only slightly, lower in females than in males. There was no statistically significant difference in DDH indices observed between left and right hip. All 3DUS indices varied significantly between anterior and posterior section of the hip. Mean 3D indices of α angle and FHC were significantly lower anteriorly than posteriorly: α(Ant) = 58.2° (SD 6.1°), α(Post) = 63.8° (SD 6.3°) (p < 0.001), FHC(Ant) = 43.0 (SD 7.4), and FHC(Post) = 55.4° (SD 11.2°) (p < 0.001). Acetabular rounding measured byOCR indices was significantly greater in the anterior section of the hip (p < 0.001). CONCLUSION: We used 3DUS to show that hip shape and normal growth pattern vary significantly between anterior and posterior regions, by magnitudes similar to age-related changes. This highlights the need for careful selection of the Graf plane during 2D ultrasound examination. Whole-joint evaluation by obtaining either 3DUS or manual ‘sweep’ video images provides more comprehensive DDH assessment. Cite this article: Bone Jt Open 2022;3(11):913–923. The British Editorial Society of Bone & Joint Surgery 2022-11-28 /pmc/articles/PMC9709493/ /pubmed/36440537 http://dx.doi.org/10.1302/2633-1462.311.BJO-2022-0081.R1 Text en © 2022 Author(s) et al. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial No Derivatives (CC BY-NC-ND 4.0) licence, which permits the copying and redistribution of the work only, and provided the original author and source are credited. See https://creativecommons.org/licenses/by-nc-nd/4.0/
spellingShingle Children’s Orthopaedics
Hareendranathan, Abhilash R.
Wichuk, Stephanie
Punithakumar, Kumaradevan
Dulai, Sukhdeep
Jaremko, Jacob
Normal variation of infant hip development: patterns revealed by 3D ultrasound
title Normal variation of infant hip development: patterns revealed by 3D ultrasound
title_full Normal variation of infant hip development: patterns revealed by 3D ultrasound
title_fullStr Normal variation of infant hip development: patterns revealed by 3D ultrasound
title_full_unstemmed Normal variation of infant hip development: patterns revealed by 3D ultrasound
title_short Normal variation of infant hip development: patterns revealed by 3D ultrasound
title_sort normal variation of infant hip development: patterns revealed by 3d ultrasound
topic Children’s Orthopaedics
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9709493/
https://www.ncbi.nlm.nih.gov/pubmed/36440537
http://dx.doi.org/10.1302/2633-1462.311.BJO-2022-0081.R1
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