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Study highlights importance of radiographic follow-up in infants with normalized DDH
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Results of this study indicate that continued follow-up with a single-view anteroposterior radiograph to monitor infants aged 6 months and 12 months who have normalized dysplasia of the hip may be important for early diagnosis and intervention of residual acetabular dysplasia.
Researchers reviewed clinical documents and radiographs of 115 infants with normalized dysplasia of the hip (DDH) who presented at their institution between January 2008 and January 2012. There were 79 infants whose DDH normalized with a Pavlik harness (PH group) and 36 infants whose DDH normalized without treatment (RF group). Overall, patients achieved normalized DDH at 3.1 months of age.
Radiographs were analyzed for evidence of acetabular dysplasia based on acetabular index (AI) at 6 months and 12 months. Researchers calculated the effective radiation dose for an anteroposterior (AP) radiograph, as well as estimating the risk of exposure-induced death.
During follow-up, radiographic results showed residual acetabular dysplasia in 17% of infants at an average age of 6.6 months. At an age of 6 months, the RF group tended to have an increased incidence of acetabular dysplasia compared with the PH group. Investigators also found the RF group had a significantly higher AI at 6 months.
Radiographic follow-up of 106 patients who were not treated with an abduction brace at 6 months of age showed 33% had acetabular dysplasia at a mean age of 12.5 months. This group consisted of more PH patients than RF patients. At 12-months, the PH group and RF group had similar dysplasia rates (34% vs. 31%, respectively) and a similar AI.
The effective radiation dose for an AP pelvic radiograph at the age of 6 months was 0.003 mSv and 0.006 mSv at 12 months of age. The risk of induced death from cancer by way of a single-view AP radiograph was less than one per million at the age of 6 months and 12 months, according to researchers.
“The notable incidences of radiographic dysplasia after previous DDH normalization in our study cohort appear to outweigh the risks of radiation exposure,” the researchers wrote. ‒ by Monica Jaramillo
Disclosures: Sarkissian reports no relevant financial disclosures. Please see the full study for a list of all other authors’ relevant financial disclosures.
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Sarkissian EJ, et al. J Pediatr Orthop. 2015;doi:10.1097/BPO.0000000000000326.
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