title: A new sign in the standard hip ultrasound image of the Graf method.
abstract: OBJECTIVE
  The aim of the study was to assess the usefulness of obtaining a 900 angle between the plane of the osteochondral plate and the surface of the transducer during standard hip ultrasonography according to Graf method.
  
  
  METHODS
  In this retrospective study 1078 patients (2156 hips) were included examined between 2008 and 2014 for developmental dysplasia of the hip (DDH) ultrasound screening. The patients were divided in two groups. Group I consisted of 402 patients examined between January 2008 and December 2011 using the standard Graf method. Group II consisted of 676 patients examined from January 2012 to December 2014 using the Graf method with an additional criterion: 900 angle between the plane of the osteochondral plate and the surface of the transducer.
  
  
  RESULTS
  We found more dysplastic patients in group I comparing to group II: 55 (13.7%) and 38 (5.6%) respectively. The difference in the incidence of patients diagnosed with DDH was highly significant (p<0.001). The mean alpha angle value in group I was 65.310, respectively 67.520 for group II (p<0.001).
  
  
  CONCLUSIONS
  The new osteochondral plate sign has the potential to reduce the overdiagnosis of DDH and provide a better tailored approach to borderline hips.
authors.affiliation: Radiology Desk, "Iuliu Hațieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania.
authors.forename: Dan
authors.initials: D
authors.lastname: Vasilescu
authors.affiliation: Pediatric Surgery and Orthopedics, "Iuliu Hațieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania. dicosma@gmail.com.
authors.forename: Dan
authors.initials: D
authors.lastname: Cosma
authors.affiliation: Pediatric Surgery and Orthopedics, "Iuliu Hațieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania.
authors.forename: Dana Elena
authors.initials: DE
authors.lastname: Vasilescu
authors.affiliation: Radiology Desk, "Iuliu Hațieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania.
authors.forename: Carolina
authors.initials: C
authors.lastname: Botar Jid
authors.affiliation: Radiology Department, Emergency County Clinical Hospital, Cluj-Napoca, Romania.
authors.forename: Mirela
authors.initials: M
authors.lastname: Gersak
authors.affiliation: Radiology Desk, "Iuliu Hațieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania.
authors.forename: Manuela
authors.initials: M
authors.lastname: Lenghel
authors.affiliation: Radiology Desk, "Iuliu Hațieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania.
authors.forename: Sorin Marian
authors.initials: SM
authors.lastname: Dudea
mesh_terms: D005260:Female; D006618:Hip Dislocation, Congenital / Q000000981:diagnostic imaging*; D006621:Hip Joint / Q000000981:diagnostic imaging*; D006801:Humans; D007223:Infant; D008297:Male; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012307:Risk Factors; D014463:Ultrasonography