Child Orthopedics


Frequently Asked Questions

Our baby has dislocating hips. For the next few weeks at least she must wear a special harness. It holds her hips and knees up toward the chest and apart from each other. I'm supposed to take her in to the clinic every week for ultrasound studies of the hip. I'm worried the exposure to radiation could harm her. What should I do?

Ultrasound can be used right at birth too look at the hips of infants at risk or with suspicious clinical findings. It is safe, does not expose the child to radiation, and seems to be well-tolerated (by the child who is being tested and by the parent who is watching). Such an early diagnosis makes it possible to achieve better results with less treatment. There are many advantages to having in-office ultrasound studies. Now it's possible for your doctor to diagnose hip problems earlier than ever before. Ultrasound makes it much easier to confirm the position of the hip. It can even be be done with the child in the harness. Using serial (weekly) ultrasound studies, it is possible to see if the hip is going to stabilize in the Pavlik harness. This is usually clear in the first week of wear. Serial (once-a-week) in-office ultrasound imaging is recommended for all children who have a dislocating hip that can be reduced (put back in place by hand). Research shows that some children need to wear the harness longer than others. If there is some laxity (looseness) in the joint, then three months of harness wear may not be long enough. Ultrasound testing makes it possible to identify children who need extended time in the harness. Another potential problem could be ligaments that are too loose so that even with the Pavlik harness, the result would not be good. That child may need a semirigid brace called an abduction orthosis. The use of ultrasound makes it possible to see these things quickly and make necessary changes in the treatment approach.

Vineeta T. Swaroop, MD, and Scott J. Mubarak, MD. Difficult-to-Treat Ortolani-Positive Hip: Improved Success with New Treatment Protocol. In Journal of Pediatric Orthopaedics. April/May 2009. Vol. 29. No. 3. Pp. 224-230.

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