Imaging Baby Hips – DDH

One of Dr Brian Loh’s favourite things to treat as an orthopaedic surgeon is hip dysplasia.  DDH is a problem that if diagnosed early and managed well is entirely curable, leading to the normal development and function of the hip joint.

When babies are investigated for DDH, Dr Brian Loh will refer them for an ultrasound, and as they get older, he will transition to x-ray.

A baby’s bones are primarily cartilaginous at birth, for which the birth canal is very thankful!  However, this means they do not show up on x-ray very well.

Consequently, Dr Brian Loh uses Ultrasound to see the hip bones.  The quality of the pictures we get from ultrasound are dependent on the sonographer’s skill, a bit like different photographers produce different quality photos.

As a baby get older, the cartilage ends of the bones get more and more calcified. Generally, at about 6 months of age there is a bony nucleus in the head of the femur (thigh bone) and it is now time for x-ray’s to be used to get a good view of the hip bones.

Xrays do contain radiation, and Dr Loh uses the minimum number of x-rays possible to adequately monitor how the hips are growing. X-rays are also less dependent on the “photographer” to get a good image.

If DDH is missed or failed to be managed appropriately, many more x-rays and CT scans will be needed to help diagnose any problems, and the surgery that Dr Brian Loh will need to perform is much more complex. 

So, ultrasounds and x-rays offer images of the hip at different times in a child’s life.