Ellen C. Benya MD, Presenter: Nothing to Disclose

Erik C. King MD, Abstract Co-Author: Nothing to Disclose

To evaluate the added value of stress imaging in hips with normal Graf alpha angles.

With IRB approval, reports from screening hip ultrasounds (SHU) with static and dynamic images over a 7 month period were retrospectively reviewed. Static coronal images were performed by a pediatric sonographer and stress images by a pediatric radiologist. Patient's age, sex, study indication, Graf alpha angle (GAA) and stress results for each hip were reviewed.

462 hips were studied in 231 children (148 girls, 83 boys) who were 3 to 117 days old, 9 were 10 weeks of age. Indications included breech presentation (44.1%), hip click (29%), twin (10.4%), family history (3.5%) and other/unknown (13%). 45 hips were immature or dysplastic with GAA < 60 degrees and orthopedic treatment and/or follow up US was recommended. 417 hips had normal GAA, with normal stress imaging in 401 and laxity or subluxation without dislocation seen in 16 hips in 11 infants. Of these 11 infants, 4 had normal f/u hip US, 2 had normal f/u orthopedic hip exam and 5 were not reevaluated by US or orthopedic consultation.

In our retrospective study there appeared to be limited added diagnostic value to stress imaging in infants with a normal GAA.

Elimination of stress images in infants with normal GAA on screening hip US would result in decreased exam cost and time savings for the radiologist.

Benya, E, King, E, Screening Hip US: Stress Views in Infants with Normal Graf Alpha Angles.  Radiological Society of North America 2006 Scientific Assembly and Annual Meeting, November 26 - December 1, 2006 ,Chicago IL. http://archive.rsna.org/2006/4435391.html