Standardization and Optimization of Ultrasonographic Graf Method Used in Diagnosis of Developmental Hip Dysplasia

Purpose: Our aim is to standardize the position of the baby in ultrasonographic Graf method used in diagnosis of developmental hip dysplasia by keeping the baby in an appropriate position. Thus, we target to increase the quality of the hip ultrasonography examination. Methods: Medical secretaries working in the ultrasound clinic were given standardization training on how to keep the baby in an immobile position in hip ultrasonography performed by Graf method. 114 babies (65 (57%) girls and 49 (43%) boys) underwent hip ultrasonography before the training. After training, a total of 169 babies (95 (56%) girls and 74 (54%) boys) hip ultrasonography examinations were performed. Before and after training; duration of examination, type of the hip determined, the anxiety level of baby’s mother during examination and satisfaction rate of both mother and radiologist were evaluated mutually. Results: After the training, examination period became shorter (131s(±15.5) vs 38s(±11.8); t=54.255, p=0.000). The number of crying babies decreased (？？ 2= 21.696, p=0.000). Mother’s level of anxiety decreased (2.03(±0,8) vs. 2.64(±0,9); t=5.778, p=0.000). Both mother’s and the radiologist’s satisfaction rate with examination increased (5.92(±1.46) vs 9.17(±0.87); t=-21.287, p=0.000, 6.14(±1.01) vs 8.97(±0.84); t=-24.531, p=0.000, respectively). It was observed that the number and rate of type 2a hips decreased (12.1% [41/338]vs 22.3% [51/228]). Conclusion: When standardized hip ultrasound examination is performed the using help of an educated medical secretary and mother, ultrasound examination became easier to perform. Thus, quality of examination is increased. This method could establish a standardization at a national level in DDH scanning