Automated Dynamic 3d Ultrasound Assessment Of Developmental Dysplasia Of The Infant Hip

Dynamic two-dimensional sonography of the infant hip is a commonly used procedure for developmental dysplasia of the hip (DDH) screening by many clinicians. It however has been found to be unreliable with some studies reporting associated misdiagnosis rates of up to 29%. Aiming to improve reliability of diagnosis and to help in standardizing diagnosis across different raters and health-centers, we present a preliminary automated method for assessing hip instability using threedimensional (3D) dynamic ultrasound (US). To quantify hip assessment, we propose the use of femoral head coverage variability (.FHC3D) within US volumes collected during a dynamic scan which uses phase symmetry features to approximate the vertical cortex of the ilium and a random forest classifier to identify the approximate location of the femoral head. We measure the change in FHC3D across US scans of the hip acquired under posterior stress vs. rest as maneuvered during a 3D dynamic assessment. Our findings on 38 hips from 19 infants scanned by one orthopedic surgeon and two radiology technicians suggests the proposed.FHC3D may provide a good degree of repeatability with an average test-retest intraclass correlation measure of 0.70 (95% confidence interval: 0.35 to 0.87, F(21, 21)= 7.738, p< 0.001). This suggests that our 3D dynamic dysplasia metric may prove valuable in improving reliability in diagnosing hip laxity due to DDH, which may lead to a more standardized DDH assessment with better diagnostic accuracy. The long-term significance of this approach to evaluating dynamic assessments may lie in increasing early diagnostic sensitivity in order to prevent dysplasia remaining undetected prior to manifesting itself in early adulthood joint disease.