Discrepancy between sonographic and radiographic values after ultrasound-monitored treatment of developmental dysplasia of the hip

Abstract

Introduction: The purpose of the study was to examine the accordance between the actually used sonographic and radiographic standard values after ultrasound-monitored treatment of developmental dysplasia of the hip (DDH). Material and methods: One hundred and fifty-three (119 children) ultrasoundmonitored treated hips (initial staging according to Graf: type IIc-IV) which attained normal ultrasound findings (type I according to Graf) during treatment and underwent an anteroposterior radiograph of the pelvis at the time of starting walking (mean age 18.6 months) were evaluated retrospectively. Results: While all hips showed normal sonographic values (Graf type I), 26 (17%) showed mild and 17 (11.1%) severe dysplasia (by measuring the acetabular index) according to the radiographic Toennis classification system, and 29 (19%) showed mild and 48 (31.4%) severe dysplasia according to the Wiberg centre-edge angle. Conclusions: This data show that the actually used sonographic and radiographic standard values concerning DDH do not correlate appropriately. It must be put up for discussion whether the radiographic standard values might be too strict. Further criteria must be developed to better assess the prognosis of residual dysplasia.