Colour Doppler Ultrasound Assessment of the Normal Neonatal Hip

Abstract

Objective To determine the morphology and hemodynamic characteristics of the arterial vessels of the proximal femur according to specific anatomic regions in asymptomatic neonates in 2 pediatric-based health care institutions. Methods Forty-three neonates (29 female, 14 male; age range, 2 d–3 mo; median age, 3 d) were enrolled in the study. Thirty-two (37%) of 86 hips were classified as Graf type IIA joints (mean alpha angle, 56.0° ± 2.7°), and 54 (63%) were classified as type I joints (mean alpha angle, 65.0° ± 4.6°). Results Colour and spectral Doppler imaging identified vessels running along the acetabular labrum, epiphyseal vessels, and femoral neck. We showed 4 different patterns of vascularity of the hips: radial, parallel, mixed radial–parallel, and indeterminate, however, they were not related to the hip maturity ( P = .3, coronal plane; P = .62, transverse plane) or to the amount of colour pixels identified in each region ( P = .35). The mean number of pixels in the ligamentum teres region was significantly higher than that in other regions of interest ( P = .03). Except for the acetabular labrum arteries, Doppler spectrum waveforms of proximal femur arteries presented with low resistivity. There was a tendency towards females' acetabular arteries presenting with lower peak systolic velocities than males' acetabular arteries ( P = .06). Conclusions Colour Doppler spectrum waveforms and intensity of vascularity in normal neonatal hips differ according to the anatomic region under evaluation. This observation deserves further investigation on its role on the physiopathogenesis of neonatal hip disorders.