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肌肉骨骼超声:诊断髋关节发育不良的有用工具:单中心经验

Musculoskeletal ultrasound: a useful tool for diagnosis of hip developmental dysplasia: One single-center experience.

作者信息

Mureşan Simona, Mărginean Maria Oana, Voidăzan Septimiu, Vlasa Ionuţ, Sîntean Ioana

机构信息

Physiology Department.

Pediatric Department No. 3.

出版信息

Medicine (Baltimore). 2019 Jan;98(2):e14081. doi: 10.1097/MD.0000000000014081.

Abstract

Developmental dysplasia of the hip (DDH) is one of the most common congenital abnormalities of the musculoskeletal apparatus in newborns. The aim of this study was to analyze the contribution of ultrasonography in the detection of DDH in newborns and infants, identifying the regional incidence of this pathology in the central area of Romania, emphasizing the risk factors that underlie DDH etiopathogenicity.This article represents a retrospective study of 847 newborns and infants examined in the Imagistic Department of a medical center from the central area of Romania, between January 1 and December 31, 2016. The ultrasound examinations were performed for the bilateral coxofemoral joints, using the method and technique described by Graf. For subjects born in the same medical center, data regarding mother's age, birth weights, and type of delivery (natural vs. caesarian section) were statistically analyzed.In our study group, the frequency of ultrasound diagnosis obtained from the examinations of right and left hips showed that the most frequent stage was type IA, and the rarest stage was III. The IA stage of right coxofemoral joints (87.3%) was higher than in the left coxofemoral joints (87.2%). The incidence of hip dysplasia (type III) diagnosed with ultrasound examinations in subjects from the central area of Romania was 0.2% (0.1% in both hips and 0.1% for the left coxofemoral joint).The musculoskeletal ultrasound examination is effective in early detection of hip dysplasia. The implementation of national and regional programs that promote indications, risk factors, and the screening age for DDH in both rural and urban areas could be a step forward in the early diagnosis of hip dysplasia for newborns and infants. The low incidence of DDH from our study group is not able to identify the role of advanced age of the mother, high birth weight of the newborn, or caesarean section as risk factors involved in the etiology of hip dysplasia. The implementation of national and regional programs that promote the musculoskeletal ultrasound as a screening imagistic investigation for DDH, in both rural and urban areas, could be a step forward in the early diagnosis of hip dysplasia for newborns and infants.

摘要

发育性髋关节发育不良(DDH)是新生儿最常见的肌肉骨骼系统先天性异常之一。本研究的目的是分析超声检查在新生儿和婴儿DDH检测中的作用,确定罗马尼亚中部地区该疾病的区域发病率,强调DDH发病机制的危险因素。本文是对2016年1月1日至12月31日期间在罗马尼亚中部地区一家医疗中心影像科接受检查的847名新生儿和婴儿进行的回顾性研究。使用Graf描述的方法和技术对双侧髋股关节进行超声检查。对于在同一医疗中心出生的受试者,对母亲年龄、出生体重和分娩类型(自然分娩与剖宫产)的数据进行了统计分析。在我们的研究组中,从左右髋关节检查获得的超声诊断频率显示,最常见的阶段是IA型,最罕见的阶段是III型。右髋股关节的IA期(87.3%)高于左髋股关节(87.2%)。罗马尼亚中部地区受试者经超声检查诊断为髋关节发育不良(III型)的发病率为0.2%(双侧均为0.1%,左髋股关节为0.1%)。肌肉骨骼超声检查对早期发现髋关节发育不良有效。在农村和城市地区实施促进DDH适应症、危险因素和筛查年龄的国家和地区计划,可能是新生儿和婴儿髋关节发育不良早期诊断的一个进步。我们研究组中DDH的低发病率无法确定母亲年龄较大、新生儿出生体重较高或剖宫产作为髋关节发育不良病因中的危险因素的作用。在农村和城市地区实施促进肌肉骨骼超声作为DDH筛查影像检查的国家和地区计划,可能是新生儿和婴儿髋关节发育不良早期诊断的一个进步。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/001d/6336624/384a05506ae7/medi-98-e14081-g002.jpg

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