Ultrasound of the hip of a newborn (screening of Developmental Dysplasia of the Hip)
A simple, quick examination helpful in the early diagnosis of developmental dysplasia of the hip (DEA).
Because full recovery of a dysplastic hip is quicker and more complete when diagnosed early, the best time to carry out the ultrasound is between 6 and 8 weeks of life.
It should be performed as a screening, i.e. for all children, but particular attention should be paid to children with risk factors for DEA: family history, breech presentation, oligohydramnios, macrosomia, twins, and specific signs.
The examination is performed by placing the child on its side with the help of a Graf positioner. Images are then obtained, on which angles are measured. This makes it possible to categorise the hip as a specific type according to the Graf method.
Transfontanellar cerebral ultrasound scan
The study of the brain using ultrasound is done through the anterior fontanella. It can therefore be carried out on newborns and on infants until the fontanella closes. It is essential in cases of prematurity, enlarged cranial circumference, pre and postnatal infections, congenital abnormalities, microcephaly, coagulation disorders, abnormalities on the prenatal ultrasound, neurological disorders, perinatal suffering, convulsions, mother with vertical transmission infection, monochorionic twins, facial dysmorphism, congenital cardiopathy, hypotonia, metabolic and neuromuscular diseases, and genetic syndromes.
In the young child in the second month of life, the spinal cord and adjacent structures can be detected using ultrasound due to the incomplete ossification of the spine. This type of ultrasound should be performed for the diagnosis of bone marrow abnormalities in children with lesions in the lumbosacral area such as tufts of hair, hemangiomas, dimple fistulae or subcutaneous masses
Ultrasound scanning of cranial sutures
This type of ultrasound provides good visualisation of the superficial structures, and makes it possible to rule out fusion of the cranial bones in the region of the sutures. It is carried out on newborns and infants with suspected craniostenosis.
Ultrasound scan of the neck
This is important in the diagnosis of thyroid disease, diseases affecting the salivary glands, and lymphadenopathy. Moreover, it is helpful when investigating the sternocleidomastoid muscle, which could be involved in postural abnormalities in the newborn and the small infant
In addition to emergency situations, ultrasound provides good results in cases of pneumonia in children, enabling the diagnosis and follow-up of pulmonary thickening, reducing or removing the need for radiography.
Ultrasound of the skin and subcutaneous tissue
Ultrasound is helpful in the identification and characterisation of cutaneous or subcutaneous skin lesions such as cysts, lymphoma, hemangiomas, or in the study of lymphadenopathy
It enables the investigation of abdominal organs such as the liver, gallbladder and biliary tract including, spleen, pancreas, kidneys and bladder. It also enables investigation of the abdominal vessels using Doppler. It is carried out in the event of abdominal pain, volumetric increase of some abdominal organs, repeated vomiting in the newborn (for the diagnosis of hypertrophic stenosis of the pylorus). Appendicitis can also be diagnosed by ultrasound examination in some cases. Preparation varies according to the age of the children.
This makes it possible to study the kidneys, urinary tract and bladder. This examination is suitable for the prenatal diagnosis of malformations (eg pyelectasis or hydronephrosis), infections of the urinary tract, and where there is a family history of renal conditions (eg renal cysts). It can also be helpful in some syndromes that may include renal or urinary abnormalities. The kidneys are investigated in both supine and prone positions.
This facilitates investigation of the pelvic organs, mainly in females (uterus and ovaries), but can also be performed on males to study the bladder. This type of ultrasound is carried out in the event of pelvic pain, suspected pathological growths, suspected precocious puberty, and in premature breast development. The examination usually needs to be carried out on a full bladder. Images are obtained with the child in a supine position; on completion of the examination the child needs to empty the bladder so that any urine residues can be assessed.
Helpful in the diagnosis of hydrocele, cryptorchidism or, in emergencies, in testicular torsion