the baby’s hip must be dynamically scanned with coronal and transverse evaluation with the hip in:
- neutral
- abduction/adduction
- flexion with and without stress
patient position
there are numerous ways that you can scan the baby.
- lie the baby supine (have the baby’s feet facing you).
- the baby can lie decubitus with a pillow/towel rolled up at the back to give them support.
- using a specific ‘cradle’. *
*please note that we feel a cradle is not ideal to use as it does not allow movement of the baby’s leg to assess dislocation with stress in adduction ,abduction, flexion or extension.
the graf chd classification
this method is adopted less commonly with the dynamic assessment and depth of coverage seen more favourable using modern equipment. a coronal view of the hip is obtained with:
- the ilium horizontal.
- a sharp, well defined acetbular roof.
- a rounded femoral head.
draw:
- the baseline: along the ilium, through the femoral head.
- the roof line: along the acetablular roof intersecting the baseline.
- the inclination line: across the top of the femoral head, through the labrum and intersecting the 1st two lines.
ultrasound criteria
- subluxable: yes/no
- laxity: yes/no
- bony coverage of fce : _____%
(most manufacturers have a %coverage calculator on the machine)- alpha angle: ____ � beta angle: ____ �
- acetabular promontory: angular/rounded/flat