Sonographic evaluation of the infant hip

Examination of the infant hip with real-time ultrasound provides an effective alternative for detecting congenital hip subluxation, dislocation, and/or dysplasia. Sonography permits visualization of the cartilaginous structures of the femoral head and acetabulum which are not seen radiographically, except by arthrography. A lateral approach using orthogonal planes (transverse and coronal) has been most reliable in establishing the anatomic relationships. In addition, the real-time mode permits a dynamic examination which can be performed in the same manner as a clinical evaluation of the hip. Furthermore, the examination is rapid, is done without sedation, and does not expose the infant to ionizing radiation. In institutions where sonographic examination of the hip has become a routine clinical evaluation, there has been an initial period of close cooperation between the sonographer and the referring clinicians. In this way, while experience is gained, each discipline comes to understand the information which sonography provides and develops confidence in the method.