This was a 10 day old infant not moving the left lower limb with tenderness on left hip movement passively . Clinical suspicion was developmental dysplasia of hip and was referred for a scan .

please visit the following site for good line diagrams.

http://bonepit.com/Reference/Neonatal%20hip%20Ultrasound.htm

The following images were secured .

This was diagnosed as type II C  of Graf

alpha angle was 45.5

the next picture is the normal right hip for comparison

right hip for comparison .
alpha angle is 54.6- normal

transverse view

Kindly visit the following link for a brief info on Graf  classification ;

http://radiopaedia.org/articles/ultrasound-classification-of-ddh  .

Graf proposed an ultrasound classification system for infant hips (see Developmental Dysplasia of the Hip (DDH) ) combining both alpha and beta angles. There are a number of additional subdivisions, which are often not used clinically.

As a general rule, the alpha angle determines the type and in some instances the beta angle is used to determine subtype.

• type I : alpha angle > 60 degrees  (normal)
  • type Ia : beta angle < 55 degrees
  • type Ib : beta angle > 55 degrees
• type II
  • type IIa : alpha angle 50 – 59 degrees
  • type IIb : alpha angle 50 – 59 degrees
  • type IIc
    • alpha angle 43 – 49 degrees
    • beta angle < 77 degrees
• type D (“about to decenter”)
  • alpha angle 43 – 49 degrees
  • beta angle > 77 degrees
• type III : alpha angle < 43 degrees
  • type IIIa and IIIb distinguished on the grounds of structural alteration of the cartilaginous roof
• type IV
  • alpha angle < 43 degrees
  • dislocated with labrum interposed between femoral head and acetabulum

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2903126/

In the Graf method, with the infant in a lateral decubitus position, coronal images of the hip joint are obtained, and α and β angles are measured. Mature hips are defined as those having an α angle of 60 degrees or greater, and are classified as types Ia or Ib, depending on the β angle. Hips with an α angle of 50 to 59 degrees are defined as immature, and are classified as types IIa or IIb, depending on the infant’s age. Hips with an α angle of 49 degrees or less are defined as having pathological development, and are classified as types IIc, D, IIIa, IIIb, or IV

If evidence of instability is present, a Pavlik harness should be considered and, if used, fitted appropriately