Hip sonography according to Graf: practical notes for the student, the examiner and the reviewer.

Abstract

Since the publication of Professor Reinhard Graf's work in 1980, Graf's technique has become the gold standard forscreening Developmental Dysplasia of the Hip (DDH) in many European and non-European countries. Despite the fact thatit is supported by robust literature evidence, there is criticism about its reliability and reproducibility, questioning severalaspects of the diagnostic procedure. There is, however, concern, based on recent literature, about the quality and reliability ofthe published data, which may, in many cases, be based on inadequate scans, and therefore any conclusions drawn have to bequestioned. The aim of this review is to demonstrate the most important aspects of Graf's technique, to clarify the potentialsources of confusion and to flag up the most common errors and mistakes made, either during the ultrasound examination, orduring the reporting procedure. Furthermore, this review can be used as a guide for reviewers and editors and should help toenhance the quality control of publications on this subject.