[Role of echography in the diagnosis and treatment monitoring of congenital acetabular dysplasia. Personal experience with 2000 examined children].

Since 1987 the authors have used sonography (US) as the means to detect dysplasia and congenital dislocation of infant hips, to define severity of the disease, and to monitor the results during treatment. In this paper the authors report their experience in 2000 examined babies. In 20 young patients, mainly females, 25 pathologic joints were detected and classified as 2c-4 hips. Orthopedic treatment employed Pavlick harness and, in case of partial success, Milgram abduction pillow too. This treatment has always been successful, except for a case with severe dislocation with echostructural changes in the acetabular cartilage. In this case, surgery was necessary. "Delayed ossification" (type 2b hips) and physiological immatury (type 2a hips) with alpha angle greater than or equal to 55 degrees were not splinted in abduction: normal maturity has always been attained without dysplastic involutions. Our experience confirmed US value in the early diagnosis of congenital acetabular dysplasia, when clinics exhibited evident limitations. Nonetheless, management and economical problems are still to be solved, due to the relationship of the widespread use of US in infant population and to its successful results, also considering the low incidence of the examined pathologic condition.