Pediatric hip sonography is the gold standard screening and diagnostic tool for developmental dysplasia of the hip (DDH) in infants. It uses high-resolution ultrasound to evaluate acetabular morphology, femoral head coverage, and hip joint stability in newborns and infants up to approximately six months of age, before ossification of the femoral head makes X-ray assessment meaningful.
The Graf classification system grades acetabular development based on bony and cartilaginous roof angles measured from standardized coronal images. Dynamic examination using the Barlow and Ortolani maneuvers under ultrasound visualization assesses joint stability and reducibility. Asymmetric hip creases or risk factors such as breech presentation, family history, and oligohydramnios prompt referral for hip ultrasound.
Pediatric hip sonography is a specialized application performed in children’s hospitals, orthopedic practices, and pediatric radiology departments. Sonographers typically hold RDMS credentials with additional pediatric training. Accurate technique and correct positioning are essential for valid Graf classification, and many institutions require dedicated competency assessment before independent practice.