Orhan AVCI, Elanur AVCI, Bilgesu ARIKAN ERGÜN
Advanced Radiology and Imaging - 2026;3(2):50-57
Objectives: Developmental dysplasia of the hip (DDH) is an important disorder in which delayed diagnosis may lead to persistent deformity, functional impairment, and premature osteoarthritis. Although a positive family history is a recognized risk factor and commonly prompts early ultrasonographic screening, the need for imaging follow-up after a normal initial ultrasound remains uncertain. Methods: In this retrospective study, records of 842 children screened ultrasonographically for DDH were reviewed. Children with bilateral Graf type I hips, a positive family history of DDH, and at least one subsequent imaging examination were included. The final cohort comprised 243 children. Follow-up consisted of repeat ultrasonography or anteroposterior pelvic radiography. Radiographs were assessed using Hilgenreiner, Perkin, and Shenton lines and acetabular angle measurements. Results: The mean age was 10.3 months, and 172 children (70.8%) were female. Eighty-nine patients underwent repeat ultrasonography, and none showed abnormal ultrasonographic or physical examination findings. The remaining 154 patients underwent follow-up pelvic radiography; the Shenton line was preserved and the upper femoral epiphysis remained within the expected inferomedial quadrant in all cases. The mean acetabular angle was 25.4+/-0.7 derece. In seven patients with serial radiographs, initially higher acetabular angles decreased to below 21 derece. Nine patients had multiple risk factors, with no significant difference in mean acetabular angle compared with the overall cohort. Conclusion: A positive family history appears important for initial DDH risk stratification but, in isolation, may not justify repeated imaging after a normal early ultrasound. Selective, individualized follow-up may reduce unnecessary examinations, radiation exposure, and parental anxiety.
