Recent Developments in Ultrasound Diagnostics in relation to Breech Births:
Ultrasound is suggested for:
- 2 to 6 week old infant with questionable examination, especially first-born girls
- 6 week-old with family history of hip dysplasia even when the exam is normal
- 6 week-old girl who was in the breech position even when the exam is normal
- Consider an ultrasound for 6 week-old boys who were in breech position even when the exam is normal
American Academy of Pediatrics (AAP) has guidelines for detection of hip dysplasia. These screening guidelines are dependent on the use of history, physical exam, and imaging. AAP recommends all newborns should be examined at birth for developmental dysplasia of the hip. If the exam shows instability, then referral or treatment is recommended. The hip examination is repeated at 2-4 weeks of age. An ultrasound study or referral to orthopedics is recommended when that examination is suspicious for hip dysplasia. When the hip examination is normal, then risk factors are considered. Some of the most important risk factors are positive family history of hip dysplasia and breech position in the womb. The AAP suggests that an ultrasound study at six weeks of age or an x-ray of the pelvis at 4 months of age is warranted when there is a positive family history of hip dysplasia and also for girls who were in the breech position. Even boys have a high risk for dysplasia after breech birth so imaging studies may be useful for those infants too. A recent study out of Rady Children’s hospital in San Diego questions whether the current screening practices are sufficient for babies who were in the breech position. They found that 29% of breech babies with a normal ultrasound at six weeks developed mild hip dysplasia by 4-6 months of age. The study recommended that all breech birth babies have an X-ray of the pelvis at six months of age as a possible method to reduce the risk of developing late DDH in this group of patients.[10][11]
Looking for our Brochures on Hip Dysplasia? Check them out below. If you would like to order these brochures for distribution, please contact us.
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This section is intended for physicians. Please use discretion if you are not a physician. Some images and videos contain graphic content.
The information presented is for educational purposes only and is not intended to represent the only, or best, method for prevention, diagnosis or treatment of hip dysplasia. Content in this section may represent an approach, view, statement or opinion that is intended to help stimulate thinking or enlighten discussion.
Readers are encouraged to understand that opinions vary even among the most "expert" physicians. Application of information to a particular situation is the responsibility of the individual healthcare professional. The general public is given access to this section, but patients and parents are encouraged to rely on their individual physician for guidance.
If you are a patient seeking specific answers, we recommend some questions to ask your doctor in another section of this website.