Ultrasound Examinations for Developmental Dysplasia of the Hips (DDH)

Your hospital consultant or GP thinks your child may be at risk of DDH and they have referred your child for an ultrasound examination.

This leaflet tells you about the ultrasound examination and what to expect when you attend for this appointment.

What is Development Dysplasia of the Hip (DDH)?

Development dysplasia of the hip (DDH) is when the ball shaped part of the thighbone and its socket, the hip joint, do not fit correctly together. There are varying levels of hip dysplasia, from mild to severe. The hip joint may be less stable and dislocates more easily. It is important to check that the hip joint has developed normally.

How is DDH detected?

The hips of all babies are checked at birth and at 6 – 8 weeks as part of a national screening programme. A healthcare professional will physically examine your baby. If any abnormality is suspected, your baby will be referred directly to the Paediatric Orthopaedic service for further assessment and usually for an ultrasound scan of the hips.

There are some risk factors which advise an ultrasound examination. Some of these include:

• Other family members had dislocated / dysplastic hips
• If your baby has been laid breech during late pregnancy

If your baby has clicky hips, they would be examined by a senior medic and may be referred for an ultrasound scan if required.

Early diagnosis gives the best chance for effective treatment. The condition becomes more difficult to treat as a child gets older and there is a risk of developing arthritis of the hip at a young age.

What are clicky hips?

A clicky hip usually means that the practitioner who examined your baby shortly after birth could move the thigh bone more than is usual in the hip joint.

Clicky hips in a newborn baby very rarely produce any lasting problems, but they do alert the practitioner to the possibility of instability or dislocation of the hip.

Who will perform the scan?

Your baby’s scan will be performed by a specially trained sonographer. The sonographer will give you a full explanation of what the scan involves.

How is the scan done?

You will be asked to remove your baby’s lower clothing but not the nappy. Your baby will then be laid on their side in a specially designed hip ultrasound cradle. You will be asked to hold your baby still during the examination.

A small amount of warm gel will be put on the baby’s thigh and the sonographer uses the ultrasound probe to produce images. The scan should take about 10 – 15 minutes to perform.

Will the scan hurt my baby?

Your baby may cry because they do not like being held still, but the examination is not painful. You may bring any comforters/soothers or a bottle of milk for your baby.

Timing of scans

If your baby’s hip test is positive, this ultrasound scan will be carried out at 2 weeks of age.

If the baby’s hip test is negative but there are still risk factors, then your baby will have a scan at 4 – 6 weeks of age. If your baby was born prematurely (born before 37 weeks of gestation), then the 4 – 6 weeks is worked out from your baby’s estimated delivery date (EDD). You will have been given this date during your pregnancy ultrasound scans.

Why is it important that I attend my baby’s scan?

Early detection of DDH can enable less invasive and potentially more effective corrective procedures. It is important that we carry out the scan in a timely fashion to ensure that we can treat as soon as possible. Because of this, it is important that you make every effort to attend for the scan.

What happens after the scan?

At the end of the scan, the sonographer will discuss the results with you. If the first ultrasound scan is normal, you do not need to do anything further.

If the first ultrasound scan shows that your baby’s hip is immature or has a borderline result, a repeat scan will be arranged for 4 weeks following the initial scan. Over this time, the hip may start to function normally and nothing else will be needed.

If an abnormality is seen on the second scan, you will be referred to a Specialist Children’s Orthopaedic doctor who will be able to start treatment if necessary.

Further information is available from:

NHS Choices

Telephone: 111 (when it is less urgent than 999)
Calls to this number are free from landlines and mobile phones.

Or via the website at www.nhs.uk

Reference

Ter Harr, G (2001) in Meire H, Cosgrove D, Dewbury K and Farrant P (editors); ‘Safety of Diagnostic Ultrasound’ in Clinical Ultrasound: A Comprehensive text.  Churchill Livingstone, pages 37 – 45.

Comments, concerns, compliments or complaints

Patient Experience Team (PET)

We are continually trying to improve the services we provide. We want to know what we’re doing well or if there’s anything which we can improve, that’s why the Patient Experience Team (PET) is here to help. Our Patient Experience Team is here to try to resolve your concerns as quickly as possible. The office is based on the ground floor at the University Hospital of North Tees if you wish to discuss concerns in person. If you would like to contact or request a copy of our PET leaflet, please contact:

Telephone: 01642 624719

Freephone: 0800 092 0084

Opening hours: Monday to Friday, 9:30am to 4:00pm

Email: [email protected]

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Telephone: 01642 617617

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Telephone: 01642 383551

Email: [email protected]

Leaflet feedback

This leaflet has been produced in partnership with patients and carers. All patient leaflets are regularly reviewed, and any suggestions you have as to how it may be improved are extremely valuable. Please write to the Clinical Governance team, North Tees and Hartlepool NHS Foundation Trust, University Hospital of North Tees, TS19 8PE or:

Email: [email protected]