الفهرس 
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Abstract
Early diagnosis of developmental dysplasia of the hip in newborns is
essential if treatment is to be successful. Screeing of newborns is
appropriate because developmental dysplasia of the hip has a high
prevalance and significant morbidity and is treatable. Screening by clinical
examination alone has shortcomings, and the use of sonography for
screening has been proposed (Harcke H. T. 1994). .’
Hip sonography enables an accurate and clinically rlevant evaluation
of hip maturation during the first days of human life. Experience has
shown that an integration of hip sonography into neonatal screening
programms IS useful and necessary because clinical and even
roentgenographic does not always establish a confinned diagnosis of
dysplasia (Schuler et al., 1990).
Various sonographic techniques widely spread used. It’s found by
Haller J. that the area for ultrasound examination of the pediatric pelvis is
best studied in transverse and longitudinal scans with the patient in supine
position.
In ’general, the best compromize between penetration and resolution
IS provided by a 7mm diameter, 5 MHz transducer with a short internal
focus in neonates and small infants (Ha/lerJ.O et al., 1981). Dynamic
and static sonography has become the imaging technique of choice in the
diagnosis and follow up of developmental dyspalsia of the hip. (Soholeski
et 01., 1993).
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In vienna speising Hospital and Benha University Hospital, 600
infants ”one week to 10 months” were examined by Hosny,
sonographically. Examination and interpretation of the sonographic
pictures were performed according to the principles and guidelines of
Graf. Hips classified into 4 major sonographic types:
Normal; delayed ossification; subluxation and dislocation.
Type I: ex: angle > 60, bone roof contour is good, iliac promontorya
angular or slightly rounded and the cartilage roof is covering
the head.
Type II: ex: angle is 59-43, bony roof contour is satisfactory, iliac
promontory is rounded and cartilage roof is covering the head.
Type III: ex: angle is < 43, bony roof contour is poor, iliac promontory is
flat and cartilage roof is everted.
Type IV: ex: angle is < 43, bony roof contour is poor, iliac promontory is
flat and cartilage roof is trapped between the femoral head and
the acetabular cavity. (Hosny, 1994).
Ther’s a direct correlation between the sonographic types and
treatment and follow up of cases of hip dysplasia and dislocation
According to the study of Exner, the policy of treatment recommended is
as follows:
1- Observe hips with ex: angle < 55° and > 50°. Recommend ”double
diapering” to allow the parents to do something other than waiting;
repeat examination after 4-6 weeks.
2- For dysplastic hip with no dislocation ec angle S;49°, 13<72°, prescribe
abduction brace (modified Frejka’s pillow) worn over the clothes;
repeat examination after 2-3 weeks. If no improvement occurs,
prescribe Pavlik harness.
3- For dysplastic hip with mild dislocation (ex:: :$:49°, 13> 72°, <900),
prescribe Pavilk harness; repeat examination after 2 weeks.
4- For dislocated hip (13) 90°), prescribe adhesive plaster extension; repeat
examination weekly. (Exner. /988). •
Sonographic screerung of all newborns has three principal
drawbacks:
1- In a number of infants, sonography shows minor abnormalities of both
stability and acetabular development that will resolve by a later age
without treatment.
2- The observation and treatment of these false - positive cases as well as
the process of screening every newborn, consume considerable
resources.
3- The final drawback is that the few cases of dysplasia tha.