Name of the Procedure:

Ultrasound of Infant Hips; Real-Time with Imaging Documentation and Dynamic Manipulation

Summary

This procedure is a way to examine the hips of infants using ultrasound technology. It involves real-time imaging and dynamic manipulation by a healthcare professional to check how the hip joints move and function.

Purpose

Ultrasound of infant hips is primarily used to detect and evaluate developmental dysplasia of the hip (DDH), a condition where the hip joint is not properly formed. The goal is to identify any abnormalities early so that appropriate treatment can be initiated to ensure normal hip development.

Indications

• Signs of hip instability or dislocation
• Family history of hip dysplasia
• Breech birth position
• Abnormal findings during a physical examination of the newborn
• As a routine check in infants at higher risk for hip problems

Preparation

• No special preparation is generally required.
• It may be helpful to have the infant calm and possibly feeding during the procedure to ensure stillness.

Procedure Description

1. The infant is placed on an examination table.
2. A water-based gel is applied to the hip area to ensure good contact between the skin and the ultrasound probe.
3. The healthcare professional moves the probe over the infant’s hips, capturing real-time images.
4. Dynamic manipulation involves gently moving the infant’s hip joints to see the range of motion and how the hip joint fits together.
5. Images and measurements are documented for further analysis.

Equipment:

• Ultrasound machine
• Handheld ultrasound probe

Anesthesia:

• No anesthesia or sedation is required.

Duration

The procedure typically takes around 20-30 minutes.

Setting

The ultrasound can be performed in a hospital radiology department, outpatient clinic, or specialized pediatric center.

Personnel

• A radiologist or pediatric orthopedist usually performs the procedure.
• A radiology technician may assist with operating the equipment.

Risks and Complications

This procedure is very safe, with minimal risks.

• Rarely, the gel can cause a mild skin reaction.
• There are no known risks from the ultrasound itself.

Benefits

• Non-invasive and painless
• Provides immediate information about hip joint condition
• Helps in early detection and treatment of hip dysplasia, leading to better outcomes

Recovery

• No recovery time is needed.
• Normal activities can be resumed immediately after the procedure.

Alternatives

• Physical examinations using the Barlow and Ortolani maneuvers
• X-rays (not preferred for very young infants due to radiation exposure)
• MRI in complex cases (involves sedation and higher costs)

Patient Experience

• The infant may feel mild pressure from the ultrasound probe but no pain.
• The procedure is painless and parents can often be present to comfort their child.
• The gel used is cold but harmless. Pain management is not typically needed due to the non-invasive nature of the procedure.