Radiological and etiopathogenic aspects associated with the therapeutic management of developmental dysplasia of the hip in children

Abstract

Introduction: Developmental Dysplasia of the Hip (DDH) ranges from mild instability to complete dislocations, influenced by genetic, mechanical and hormonal factors. Specific risk groups, such as female newborns with breech presentation and family history, require early diagnosis using ultrasound, radiography and magnetic resonance imaging to reduce complications and costs in the health system. Objective: This study aims to review the current knowledge about DDH, focusing on recent advances in imaging diagnostics and therapeutic strategies to improve clinical practices and establish effective intervention guidelines. Methodology: An exploratory and qualitative literature review was carried out in the PubMed, MedlinePlus, SciELO, LILACS and Google Scholar databases, covering publications from 2018 to 2023. Studies that addressed the etiology, diagnosis and treatment of DDH were selected, using related descriptors and excluding research prior to 2018 and those not directly related to the topic. Of the 20 studies identified, 9 were analyzed in depth. Results and Discussion: DDH is impacted by multiple factors, with emphasis on risks associated with gender and fetal position. Diagnosis involves clinical evaluation and imaging support, such as ultrasound in the first six months, followed by radiographs and magnetic resonance imaging. In treatment, abduction orthoses are effective at the beginning; complex cases may require surgery to correct the anatomy. The use of innovative surgical techniques and anti-inflammatories in the postoperative period show promising results, although they require continued monitoring. Final Considerations: Effective management of DDH requires a multidisciplinary approach involving pediatricians, orthopedists, radiologists and nurses, which is crucial for adequate diagnosis and treatment. Technological advances in imaging and surgery have improved outcomes, but additional studies are still needed to fill the gaps in understanding the mechanisms underlying DDH. The implementation of screening protocols and personalized therapeutic interventions are essential to ensure the quality of life of affected children.