The Phenomenon of the Apparent (Double) Femoral Head in Infant Hip Sonography According to Graf-Description, Incidence and Clinical Relevance.

Abstract

PURPOSE:

Hip screening sonography according to Graf in rare cases yields the appearance of a double femoral head, aptly named the Double-Head-Sign. The goal of this retrospective study is to offer a definition of this rare sign, evaluate its incidence of occurrence and compare the sonographic findings with the clinical findings.

MATERIALS AND METHODS:

This Double-Head-Sign is caused by the overlap of the trochanter major with the actual head of the femur in cases of coxa vara. This was observed in 13 of 2800 neonates we screened as part of our sonographical neonatal hip screening.

RESULTS:

13 neonates presented themselves with ultrasound findings in accordance with our description, yielding an incidence of 0,46% in our patient cohort. In correlation, these neonates also exhibited increased external and decreased internal rotation of the hip. Two had an underlying condition (achondroplasia).

CONCLUSION:

In these rare cases, clinical examination of hip rotation in 90° hip flexion has proved helpful and further interdisciplinary examination of such infants to distinguish a possible underlying primary condition is recommended.

• Authors: Charlotte Struwe, Rahel Bornemann, Sebastian Gottfried Walter, Sebastian Koob, Richard Placzek
• Journal: Zeitschrift fur Orthopadie und Unfallchirurgie (Z Orthop Unfall) Vol. 158 Issue 5 Pg. 462-465 (Oct 2020) ISSN: 1864-6743 [Electronic] Germany
• Vernacular Title: Das Phänomen des scheinbar (ver)doppelten Hüftkopfes bei der Säuglingssonografie nach Graf-Beschreibung, Inzidenz und klinische Relevanz.
• PMID: 31634952 (Publication Type: Journal Article)
• Copyright: Thieme. All rights reserved.

Topics

• Femur Head (diagnostic imaging)
• Hip Dislocation, Congenital (diagnostic imaging, epidemiology)
• Hip Joint
• Humans
• Incidence
• Infant, Newborn
• Retrospective Studies
• Ultrasonography