Hip sonography--how reliable? Sector scanning versus linear scanning? Dynamic versus static examination?

In Europe, the use of ultrasonography has become a routine procedure for the detection of hip dislocations and dysplasias; clinical and historical data alone are not fully reliable. Under the right conditions, ultrasonographic examination of the hip can reliably detect hip joints in need of treatment. Furthermore, results are reproducible without the use of roentgenograms; thus the danger of "overtreatment" can be avoided. The use of sector scanners for examinations of hip joints leads to distortions in the geometry of the picture. As a result, the use of linear transducer is presently indispensable. Thanks to a reference level, static examinations of the hip joint provide us with the possibility of measuring and comparing individual hip joints. With dynamic examinations, we can quantify the data and assess hip stability. In fact, the static and dynamic approaches do not exclude but, rather, complement each other. The ultrasonographic method must be learned from experts. Given the above-mentioned conditions, all developmental abnormalities of the hip can be diagnosed in the first six weeks of life, and healthy hip joints can be clearly distinguished from those requiring follow-up examination. Based on observations on 8530 cases, hip joints of infants at least 4.5 months of age can be successfully treated in a conservative manner. Femoral head necroses have disappeared altogether and the need for later surgery has decreased dramatically.