The Impact of Focused Hip Ultrasound Training on Imaging Quality in Infants With Hip Dysplasia

Ahmad Alawadhi; Kenan S Basha; Jalal Al-Shryda; Tahani Al Ali; Ajay P Dsouza; Hayder S Abdulhadi; Amar H Khamis; Ibrar Majid; Sattar Alshryda

doi:10.7759/cureus.74787

The Impact of Focused Hip Ultrasound Training on Imaging Quality in Infants With Hip Dysplasia

Cureus. 2024 Nov 29;16(11):e74787. doi: 10.7759/cureus.74787. eCollection 2024 Nov.

Authors

Ahmad Alawadhi¹, Kenan S Basha¹, Jalal Al-Shryda², Tahani Al Ali³, Ajay P Dsouza⁴, Hayder S Abdulhadi⁵, Amar H Khamis¹, Ibrar Majid⁶, Sattar Alshryda^{7

1}

Affiliations

¹ College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, ARE.
² Department of Surgery, Collm Klinik Oschatz, Oschatz, DEU.
³ Department of Orthopedics, Al Jalila Children's Specialty Hospital, Dubai, ARE.
⁴ Department of Radiology, Al Jalila Children's Specialty Hospital, Dubai, ARE.
⁵ Department of Orthopedics, Rashid Hospital, Dubai, ARE.
⁶ Department of Pediatric Orthopedics, Al Jalila Children's Specialty Hospital, Dubai, ARE.
⁷ Department of Pediatric Orthopedics and Trauma, Al Jalila Children's Specialty Hospital, Dubai, ARE.

Abstract

Background: The orthopedic department at Al Jalila Children's Specialty Hospital (AJCH) was opened in April 2018. A focused hip ultrasound training course was conducted in April 2019 to improve hip ultrasound imaging quality.

Objectives: This study aims to evaluate the impact of focused training courses on predefined image quality criteria of infant hip ultrasound in the context of developmental hip dysplasia. It also seeks to measure the inter- and intra-rater agreement among various disciplines.

Methods: A retrospective review of 120 hip ultrasound images (60 infants) was performed between April 2018 and April 2020. Based on internationally agreed criteria, 60 hip images obtained before the course were compared to another 60 hip images obtained after the course. Inter-rater and intra-rater agreements were also evaluated using intraclass correlation (ICC).

Results: The study evaluated the impact of a focused training course on the quality of infant hip ultrasound images for developmental dysplasia of the hip. Image quality significantly improved after the training, with optimal images increasing from 48% to 82% (P<0.001). Logistic regression confirmed the training's positive effect, highlighting its clinical and statistical significance. The study has also demonstrated excellent agreement among raters for alpha and beta angles, as reflected by ICC statistics. The agreement for alpha angles was notably higher than for beta angles (ICC 0.970 vs. 0.904; P<0.0001). However, inter-rater agreement for hip types, assessed using kappa statistics, was moderate (κ = 0.512) and targeted to address a limited shortfall or gaps in services.

Conclusion: The study confirms the value of focused training in improving the quality of care. This training should be carefully planned and targeted to address limited shortfalls or gaps in services in other areas of service delivery.

Level of evidence: The study is a retrospective cohort with evidence level II.

Keywords: developmental dysplasia of the hip ( ddh ); graf method; hips; neonatal screening; pavlik harness; pediatric orthopedics; pediatric ultrasound; ultrasound.