Comparative Study of Ultrasound vs. MRI in Diagnosing Pediatric Hip Dysplasia
Keywords:
Developmental dysplasia of the hip (DDH), Pediatric imaging, Ultrasound, MRI, Graf classification, Femoral head, Acetabulum, Sedation, Orthopedic diagnosisAbstract
Background: To compare the diagnostic accuracy of ultrasound and MRI in detecting DDH in pediatric patients, with an emphasis on imaging utility across different age groups and clinical scenarios.
Methods: This prospective comparative study was conducted on 69 children with suspected DDH from June 2022 to May 2023 at Pediatrics Department Frontier Corps Teaching Hospital Peshawar. All patients underwent ultrasound using the Graf method. MRI was performed in selected cases with inconclusive ultrasound findings or older age. Diagnostic findings, sensitivity, specificity, inter-modality agreement, and impact on treatment planning were analyzed.
Results: MRI demonstrated higher sensitivity (94.1%) and specificity (91.6%) compared to ultrasound (85.2% and 76.9%, respectively) with a statistically significant difference (p = 0.031). Complete agreement between the two modalities was observed in 73.9% of cases (Cohen’s Kappa = 0.67, p = 0.004). MRI altered the clinical management plan in 24.6% of cases compared to 11.6% with ultrasound (p = 0.046), though sedation was required in 88.4% of MRI procedures.
Conclusion: While ultrasound remains the first-line imaging tool for early DDH diagnosis, MRI provides superior detail and is particularly useful in older children or complex cases. A combined imaging approach enhances diagnostic precision and supports better treatment planning..
Downloads
References
Li, J., et al., Application Value of Combined Diagnosis of Ultrasound, MRI, and X‐Ray in Developmental Dysplasia of the Hip in Children. 2022. 2022(1): p. 1632590.
Duarte, M.L., et al., Ultrasound techniques for the detection of developmental dysplasia of the hip: a systematic review and meta-analysis. 2022. 141(2): p. 154-167.
Pakarinen, O., et al., A comparison of different selective ultrasound screening strategies for developmental dysplasia of the hip: a systematic review and meta-analysis. 2023. 105(3): p. 247-253.
Kilsdonk, I., M. Witbreuk, and H.-J.J.J.o.u. Van Der Woude, Ultrasound of the neonatal hip as a screening tool for DDH: how to screen and differences in screening programs between European countries. 2021. 21(85): p. e147.
Liu, D., et al., The feasibility of ultrasound Graf method in screening infants and young children with congenital hip dysplasia and follow-up of treatment effect. 2021. 10(5): p. 1333.
Litrenta, J., et al., Ultrasound evaluation of pediatric orthopaedic patients. 2020. 28(16): p. e696-e705.
Yu, J., et al., Is hip medial ultrasound more accurate than radiography for determining the status of hip reduction in children treated with a spica cast? A retrospective diagnostic accuracy study. 2023. 481(3): p. 592-605.
de Borja, C., R. Watkins, and T.J.C.r.i.m.m. Woolridge, Common ultrasound applications for pediatric musculoskeletal conditions. 2022. 15(6): p. 447-455.
Back, S.J., et al., Intraoperative Contrast‐Enhanced Ultrasound Imaging of Femoral Head Perfusion in Developmental Dysplasia of the Hip: A Feasibility Study. 2020. 39(2): p. 247-257.
Kannan, A., Uncertainty-based assessment of hip joint segmentation and 3d ultrasound scan adequacy in paediatric dysplasia measurement using deep learning. 2022, University of British Columbia.
Kay, R.H., et al., 3D ultrasound to quantify lateral hip displacement in children with cerebral palsy: a validation study. 2020. 62(12): p. 1389-1395.
Kim, S.-H., et al., A comparative study on keypoint detection for developmental dysplasia of hip diagnosis using deep learning models in X-ray and ultrasound images. 2023. 42(5): p. 460-468.
Herrero, C., et al., Point-of-care ultrasound reduces visit time and cost of care for infants with developmental dysplasia of the hip. 2021. 55(6): p. 1529-1534.
Poboży, T., et al. Basic differences and most common findings in ultrasound examinations of musculoskeletal system in children: A narrative literature review. in Healthcare. 2022. MDPI.
Hareendranathan, A.R., et al., Domain-aware contrastive learning for ultrasound hip image analysis. 2022. 149: p. 106004.
Karout, L. and L.J.R.C. Naffaa, Pediatric hip disorders: imaging guidelines and recommendations. 2022. 60(1): p. 149-163.
Jia, H., et al., Assessment of irreducible aspects in developmental hip dysplasia by magnetic resonance imaging. 2020. 20(1): p. 550.
Cha, Y., M.S. Kang, and S.-S.J.P.E.C. Park, Prediction of high-grade hip joint effusion with simple radiographs in children: A comparative study with magnetic resonance imaging. 2021. 37(5): p. e255-e260.
Willemsen, K., et al., Comparing hip dysplasia in dogs and humans: a review. 2021. 8: p. 791434.
Gather, K.S., et al., Outcome prognostic factors in MRI during spica cast therapy treating developmental hip dysplasia with midterm follow-up. 2022. 9(7): p. 1010..
Downloads
Published
How to Cite
Issue
Section
License
This work is licensed under a Creative Commons Attribution 4.0 International License.
You are free to:
- Share — copy and redistribute the material in any medium or format
- Adapt — remix, transform, and build upon the material for any purpose, even commercially.
Terms:
- Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.
- No additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.
