THE VALUE OF HARCKE’S ULTRASOUND TECHNIQUE FOR NEWBORN HIPS SCREENING

Abstract

Introduction: Late diagnosed developmental dysplasia of the hip joint (DDH) is now a very rare case in an orthopaedic practice. It is mostly because of early ultrasound screenings of baby’s hips. Two ultrasound techniques are most popular and widely used in the world – the Graf’s technique in Europe and Harcke’s in the USA. The purpose of this study was to establish a value of Harcke’s technique which is not very popular in Europe.

Material and Methods: During the last 10 years, 25 000 ultrasound hip examinations of newborns hips because of early DDH screening were performed in our Clinic. In every child both hips were examined using two techniques (Graf’s and Harcke’s). The mean age during the first hip ultrasound examination was 5 weeks (from 10 days to 8 weeks). The Siemens SL1 equipment with linear transducer of 7.5 MHz was used for examination. The position of the hip during examination followed all requirements indicated by Graf or Harcke. All ultrasound examination were performed and analyzed by two orthopaedic surgeons.

Results: In this study the DDH was diagnosed in 5,6% of all examined hips. Most common type of dysplastic hip was type II according to Graf’s classification, or laxity with stress according to Harcke’s classification. The cases with decentration (subluxation or dislocation) were diagnosed in 2% of all dysplastic hips. In Graf’s technique there were some differences in measuring the beta or alfa angles between examiners, however, this did not influenced the type of hip dysplasia. Harcke’s method was easy to perform because the measuring of the angles was not necessary. The time which was required for examination of a child’s hips did not extend 2 minutes.

Conclusions: Both methods are very useful in early diagnosis of DDH and could be used for general hip screening for newborn hips. Harcke’s method gives a better visualization of the hip in two planes and gives dynamic pictures.