{"id":35935,"date":"2026-09-10T16:02:22","date_gmt":"2026-09-10T16:02:22","guid":{"rendered":"https:\/\/suresultmed.com\/?p=35935"},"modified":"2026-09-10T16:34:09","modified_gmt":"2026-09-10T16:34:09","slug":"infant-hip-ultrasound-graf-method","status":"publish","type":"post","link":"https:\/\/suresultmed.com\/ja\/infant-hip-ultrasound-graf-method\/","title":{"rendered":"Infant Hip Ultrasound: the 3-Minute D3Ultra Graf Method Walkthrough"},"content":{"rendered":"<div class=\"sr-ih-2026\" data-suresult-article-root data-sr-author-voice=\"fernando-mariz-md jailyn-avila-md\">\n<style>body.postid-35935 .wd-page-title.post-title-large-image{background:#fff!important;color:#1b2426!important;min-height:0!important;height:auto!important;padding:44px 0 6px!important}\nbody.postid-35935 .wd-page-title.post-title-large-image .wd-page-title-bg{display:none!important}\nbody.postid-35935 .wd-page-title.post-title-large-image .wd-post-meta,body.postid-35935 .wd-page-title .meta-post-categories,body.postid-35935 .entry-meta{display:none!important}\nbody.postid-35935 .wd-page-title .wd-post-cat{display:none!important}\nbody.postid-35935 .post-featured-image{display:none!important}\nbody.postid-35935 .wd-page-title .container{max-width:1080px!important;width:min(calc(100% - 28px),1080px)!important;padding-inline:0!important;margin-inline:auto!important;align-items:flex-start!important;text-align:left!important}\nbody.postid-35935 .wd-page-title.post-title-large-image .entry-title{color:#1b2426!important;font-family:\"Helvetica Neue\",Arial,system-ui,-apple-system,sans-serif!important;font-weight:800!important;letter-spacing:-.022em!important;line-height:1.04!important;font-size:clamp(34px,5.2vw,60px)!important;text-transform:none!important;max-width:24ch;text-wrap:balance;margin-inline:0}\nbody.postid-35935 .wd-page-title.post-title-large-image .entry-title:before{content:\"Suresult \u00b7 Scan Library \u00b7 September 2026\";display:block;font-family:ui-monospace,\"SF Mono\",\"Cascadia Mono\",Menlo,Consolas,monospace;font-size:12px;font-weight:500;letter-spacing:.18em;text-transform:uppercase;color:#b9791f;margin:0 0 24px}\nbody.postid-35935 .sidebar-container,body.postid-35935 .wd-sidebar,body.postid-35935 .widget-area{display:none!important}\nbody.postid-35935 .wd-content-layout.content-layout-wrapper{display:block!important;width:min(calc(100% - 28px),1240px)!important;max-width:1240px!important;margin-inline:auto!important}\nbody.postid-35935 .wd-content-area.site-content,body.postid-35935 .wd-entry-content{max-width:1120px!important;margin-inline:auto!important;width:100%!important}\n.sr-ih-2026{--ink:#1b2426;--ink-soft:#586669;--ink-faint:#8a9698;--rule:#d7dedc;--rule-soft:#e6ebe9;--panel:#fafbfa;--flat:#2f7d78;--flat-soft:#e2efed;--sub:#c98a2b;--sub-soft:#f3e6cf;--sub-line:#b9791f;--mono:ui-monospace,\"SF Mono\",\"Cascadia Mono\",Menlo,Consolas,monospace;--serif:Charter,\"Iowan Old Style\",\"Palatino Linotype\",Georgia,serif;--sans:\"Helvetica Neue\",Arial,system-ui,-apple-system,sans-serif;color:var(--ink);font-family:var(--serif);font-size:19px;line-height:1.68;max-width:1080px;margin:0 auto;padding:0 0 70px;-webkit-font-smoothing:antialiased}\n.sr-ih-2026 *{box-sizing:border-box}\n.sr-ih-2026 figure{margin:0}\n.sr-ih-2026 ::selection{background:var(--sub-soft);color:#1b2426}\n.sr-ih-2026 p{margin:0 0 20px;max-width:70ch}\n.sr-ih-2026 a{color:var(--flat)!important;font-weight:600;text-decoration:underline;text-underline-offset:3px;text-decoration-thickness:1px}\n.sr-ih-2026 a:hover{text-decoration-thickness:2px}\n.sr-ih-2026 strong{font-weight:700;color:var(--ink)}\n.sr-ih-2026 h2{font-family:var(--sans);font-weight:800;letter-spacing:-.018em;font-size:clamp(25px,3.4vw,34px);line-height:1.1;margin:52px 0 16px;color:var(--ink);text-wrap:balance}\n.sr-ih-2026 h3{font-family:var(--sans);font-weight:700;letter-spacing:-.01em;font-size:19px;line-height:1.25;margin:30px 0 10px;color:var(--ink)}\n.sr-ih-2026 section[id]{scroll-margin-top:110px}\n.sr-ih-2026 a:focus-visible,.sr-ih-2026 summary:focus-visible,.sr-ih-2026 button:focus-visible{outline:2px solid var(--sub-line);outline-offset:3px;border-radius:2px}\n.sr-ih-2026 ::-webkit-scrollbar{height:10px;width:10px}\n.sr-ih-2026 ::-webkit-scrollbar-track{background:var(--rule-soft)}\n.sr-ih-2026 ::-webkit-scrollbar-thumb{background:#b9c4c2;border-radius:6px;border:2px solid var(--rule-soft)}\n.sr-ih-2026 ::-webkit-scrollbar-thumb:hover{background:var(--ink-faint)}\n.sr-ih-krow{font-family:var(--mono);font-size:11px;letter-spacing:.16em;text-transform:uppercase;color:var(--sub-line);font-weight:600;display:flex;align-items:center;gap:10px;margin:52px 0 -6px}\n.sr-ih-krow:before{content:\"\";width:26px;height:2px;background:var(--sub);flex:0 0 auto}\n.sr-ih-krow+h2{margin-top:10px}\n.sr-mast{border-bottom:1px solid var(--ink);padding:2px 0 26px;margin:0 0 8px}\n.sr-ih-2026 p.sr-deck{font-family:var(--serif);font-size:clamp(19px,2.2vw,23px);line-height:1.5;color:var(--ink-soft);max-width:44ch;margin:0 0 24px}\n.sr-byline{display:flex;flex-wrap:wrap;gap:8px 22px;align-items:center;font-family:var(--mono);font-size:12.5px;letter-spacing:.02em;color:var(--ink-soft)}\n.sr-byline b{color:var(--ink);font-weight:600}\n.sr-byline br,.sr-byline>p:empty,.sr-author-panel br,.sr-author-panel>p:empty,.sr-author-grid br,.sr-author-grid>p:empty,.sr-author-card br,.sr-author-card>p:empty,.sr-author-card__head br,.sr-author-card__id br,.sr-author-meta br,.sr-ih-band__key br,.sr-ih-lines br,.sr-ih-line br,.sr-ih-scales br,.sr-ih-scale br,.sr-ih-track br,.sr-ih-axis br,.sr-ih-figrow br,.sr-light-toc__head br,.sr-light-toc__links br{display:none}\n.sr-byline__author{display:inline-flex;align-items:center;gap:9px}\n.sr-byline__author img{width:30px;height:30px;border-radius:999px;object-fit:cover;border:1px solid var(--rule);background:#fff;flex:0 0 auto}\n.sr-byline__label{display:block;width:100%;font-size:10.5px;letter-spacing:.14em;text-transform:uppercase;color:#637274}\n.sr-verified-badge{color:var(--flat);border:1px solid var(--flat);border-radius:2px;padding:2px 8px;text-transform:uppercase;letter-spacing:.1em;font-size:10.5px;font-weight:600}\n.sr-ih-stage{margin:26px 0 0}\n.sr-ih-player{position:relative;aspect-ratio:16\/9;background:#04060a;border:1px solid var(--rule);border-radius:4px;overflow:hidden;display:block;width:100%;padding:0;cursor:pointer;transition:box-shadow .45s cubic-bezier(.2,.8,.25,1),transform .45s cubic-bezier(.2,.8,.25,1)}\n.sr-ih-player img{width:100%;height:100%;object-fit:cover;display:block;filter:saturate(.9) contrast(1.02);transition:filter .5s cubic-bezier(.2,.8,.25,1),transform .8s cubic-bezier(.2,.8,.25,1)}\n.sr-ih-player:hover{transform:translateY(-2px);box-shadow:0 18px 40px -18px rgba(27,36,38,.55)}\n.sr-ih-player:hover img{filter:saturate(1.04) contrast(1.05);transform:scale(1.012)}\n.sr-ih-player iframe{position:absolute;inset:0;width:100%;height:100%;border:0}\n.sr-ih-play{position:absolute;inset:0;display:flex;align-items:center;justify-content:center;pointer-events:none}\n.sr-ih-play svg{width:82px;height:82px;filter:drop-shadow(0 6px 20px rgba(0,0,0,.55));transition:transform .45s cubic-bezier(.2,.8,.25,1)}\n.sr-ih-player:hover .sr-ih-play svg{transform:scale(1.075)}\n.sr-ih-play circle{transition:fill .45s ease}\n.sr-ih-player:hover .sr-ih-play circle{fill:rgba(201,138,43,.94)}\n.sr-ih-badge{position:absolute;left:0;bottom:0;display:flex;gap:0;font-family:var(--mono);font-size:11px;letter-spacing:.1em;text-transform:uppercase;pointer-events:none}\n.sr-ih-badge span{background:rgba(4,6,10,.82);color:#e8eeec;padding:7px 12px;border-top:1px solid rgba(255,255,255,.14);border-right:1px solid rgba(255,255,255,.14);font-variant-numeric:tabular-nums}\n.sr-ih-2026 figcaption.sr-ih-cap{font-family:var(--mono);font-size:11.5px;line-height:1.7;color:var(--ink-soft);margin:12px 0 0;max-width:84ch}\n.sr-ih-cap b{color:var(--ink-soft);font-weight:600}\n#quick-answer{background:var(--panel);border:1px solid var(--rule);border-left:3px solid var(--sub);border-radius:0 4px 4px 0;padding:26px 28px 12px;margin:34px 0 10px}\n#quick-answer h2{font-family:var(--mono);font-weight:600;font-size:12px;letter-spacing:.18em;text-transform:uppercase;color:var(--sub-line);margin:0 0 16px}\n#quick-answer p{font-size:20px;line-height:1.6;max-width:75ch}\n#quick-answer p strong{background:linear-gradient(transparent 64%,var(--sub-soft) 64%)}\n.sr-ih-2026 p.sr-answer-note{font-family:var(--mono);font-size:12px;line-height:1.7;color:var(--ink-soft);border-top:1px solid var(--rule);padding-top:14px;margin-top:4px;max-width:84ch}\n.sr-ih-band{background:var(--ink);color:#eef2f1;border-radius:4px;padding:38px 34px 30px;margin:34px 0 0}\n.sr-ih-band__eye{font-family:var(--mono);font-size:11px;letter-spacing:.2em;text-transform:uppercase;color:var(--sub);margin:0 0 12px;font-weight:600}\n.sr-ih-band h2{color:#fff;margin:0 0 10px;font-size:clamp(24px,3.2vw,32px)}\n.sr-ih-2026 p.sr-ih-band__sub{color:#a9b8b6;font-size:17px;line-height:1.55;max-width:62ch;margin:0 0 26px}\n.sr-ih-lines{display:grid;grid-template-columns:repeat(3,1fr);gap:0;border-top:1px solid rgba(255,255,255,.14);border-bottom:1px solid rgba(255,255,255,.14)}\n.sr-ih-lines br,.sr-ih-lines>p:empty,.sr-ih-line br,.sr-ih-line>p:empty{display:none}\n.sr-ih-2026 .sr-ih-line{display:block;padding:24px 24px 22px;text-decoration:none!important;color:inherit!important;font-weight:400!important;border-left:1px solid rgba(255,255,255,.1);transition:background .25s ease}\n.sr-ih-2026 .sr-ih-line:first-child{border-left:0}\n.sr-ih-2026 .sr-ih-line:hover{background:rgba(255,255,255,.05)}\n.sr-ih-line__n{display:block;font-family:var(--mono);font-size:24px;font-weight:700;color:var(--sub);line-height:1;letter-spacing:-.02em;font-variant-numeric:tabular-nums}\n.sr-ih-line__h{display:block;font-family:var(--sans);font-size:18px;font-weight:700;color:#fff;line-height:1.24;letter-spacing:-.012em;margin:12px 0 8px}\n.sr-ih-line__w{display:block;font-family:var(--mono);font-size:11px;line-height:1.6;color:#7fc4be;letter-spacing:.03em;text-transform:uppercase;margin:0 0 11px}\n.sr-ih-line__d{display:block;font-family:var(--serif);font-size:14.5px;line-height:1.56;color:#b7c4c2;margin:0 0 12px}\n.sr-ih-line__t{display:block;font-family:var(--mono);font-size:11.5px;color:var(--sub);font-variant-numeric:tabular-nums;letter-spacing:.04em}\n.sr-ih-2026 .sr-ih-line:hover .sr-ih-line__t{color:#f0d9ac}\n.sr-ih-scales{display:block;margin:26px 0 0;padding:24px 0 0;border-top:1px solid rgba(255,255,255,.14)}\n.sr-ih-scales br,.sr-ih-scales>p:empty{display:none}\n.sr-ih-2026 p.sr-ih-scales__h{font-family:var(--mono);font-size:10.5px;letter-spacing:.16em;text-transform:uppercase;color:#8b9b99;margin:0 0 22px;max-width:none}\n.sr-ih-scale{display:block;margin:0 0 42px}\n.sr-ih-scale:last-child{margin-bottom:6px}\n.sr-ih-scale br,.sr-ih-scale>p:empty{display:none}\n.sr-ih-scale__h{display:block;font-family:var(--sans);font-size:14px;font-weight:700;color:#dfe8e6;letter-spacing:-.005em;margin:0 0 10px}\n.sr-ih-track{display:flex;width:100%;height:auto;gap:2px}\n.sr-ih-track br,.sr-ih-track>p:empty{display:none}\n.sr-ih-seg{display:block;min-width:0;padding:8px 8px 9px;border-radius:2px;overflow:hidden}\n.sr-ih-seg--bad{background:rgba(201,138,43,.5)}\n.sr-ih-seg--warn{background:rgba(201,138,43,.32)}\n.sr-ih-seg--mid{background:rgba(63,157,150,.34)}\n.sr-ih-seg--good{background:rgba(63,157,150,.62)}\n.sr-ih-seg b{display:block;font-family:var(--mono);font-size:11.5px;font-weight:700;color:#fff;letter-spacing:.05em;line-height:1.2;white-space:nowrap;overflow:hidden;text-overflow:ellipsis}\n.sr-ih-seg em{display:block;font-style:normal;font-family:var(--mono);font-size:10.5px;line-height:1.4;color:rgba(255,255,255,.78);letter-spacing:.02em;margin-top:3px;overflow:hidden;text-overflow:ellipsis}\n.sr-ih-axis{display:block;position:relative;height:44px;margin-top:2px}\n.sr-ih-axis br,.sr-ih-axis>p:empty{display:none}\n.sr-ih-tick{display:block;position:absolute;top:0;transform:translateX(-50%)}\n.sr-ih-tick i{display:block;width:1px;height:7px;margin:0 auto;background:rgba(255,255,255,.34)}\n.sr-ih-tick b{display:block;font-family:var(--mono);font-size:10.5px;font-weight:500;color:#8b9b99;font-variant-numeric:tabular-nums;margin-top:3px}\n.sr-ih-mark{display:block;position:absolute;top:0;transform:translateX(-50%);text-align:center;z-index:2}\n.sr-ih-mark i{display:block;width:2px;height:15px;margin:0 auto;background:var(--sub)}\n.sr-ih-mark b{display:block;font-family:var(--mono);font-size:14px;font-weight:700;color:#f0d9ac;font-variant-numeric:tabular-nums;line-height:1.2;margin-top:3px;white-space:nowrap;background:var(--ink);padding:0 5px;border-radius:2px}\n.sr-ih-mark em{display:block;font-style:normal;font-family:var(--mono);font-size:10.5px;letter-spacing:.12em;text-transform:uppercase;color:#8b9b99;white-space:nowrap}\n.sr-ih-2026 p.sr-ih-scales__note{font-family:var(--mono);font-size:11px;line-height:1.7;color:#9aa9a7;margin:16px 0 0;max-width:82ch}\n.sr-ih-2026 p.sr-ih-band__key{display:flex;flex-wrap:wrap;gap:8px 24px;font-family:var(--mono);font-size:11px;letter-spacing:.06em;color:#9aa9a7;margin:20px 0 0;max-width:none}\n.sr-ih-band__key span{display:inline-flex;align-items:center;gap:8px}\n.sr-ih-band__key i{width:14px;height:9px;border-radius:1px;display:inline-block}\n.sr-ih-2026 p.sr-ih-band__note{font-family:var(--mono);font-size:11px;line-height:1.75;color:#9aa9a7;margin:16px 0 0;max-width:80ch}\n.sr-ih-fig{margin:26px 0 30px;border:1px solid var(--rule);border-radius:4px;overflow:hidden;background:#04060a}\n.sr-ih-fig img{display:block;width:100%;height:auto}\n.sr-ih-2026 figcaption.sr-ih-figcap{font-family:var(--mono);font-size:11.5px;line-height:1.7;color:var(--ink-soft);background:#fff;border-top:1px solid var(--rule);padding:14px 18px;margin:0;max-width:none}\n.sr-ih-2026 figcaption.sr-ih-figcap b{color:var(--ink);font-weight:600}\n.sr-table-wrap{overflow-x:auto;margin:22px 0 8px;border:1px solid var(--rule);border-radius:4px}\n.sr-ih-km{border-collapse:collapse;width:100%;min-width:720px;table-layout:fixed;font-family:var(--sans);font-size:14px}\n.sr-ih-km th{font-family:var(--mono);font-size:10.5px;letter-spacing:.13em;text-transform:uppercase;color:#637274;text-align:left;font-weight:600;padding:13px 16px;border-bottom:1px solid var(--rule);background:var(--panel);white-space:nowrap}\n.sr-ih-km th:last-child{white-space:normal}\n.sr-ih-km td{padding:15px 16px;border-bottom:1px solid var(--rule-soft);vertical-align:top;line-height:1.5;color:var(--ink-soft)}\n.sr-ih-km tr:last-child td{border-bottom:0}\n.sr-ih-km tr:hover td{background:#fcfdfc}\n.sr-ih-2026 .sr-ih-t a{font-family:var(--mono);font-size:13px;font-variant-numeric:tabular-nums;color:var(--flat)!important;text-decoration:none;border-bottom:1px solid var(--flat-soft);padding-bottom:1px}\n.sr-ih-2026 .sr-ih-t a:hover{border-bottom-color:var(--flat)}\n.sr-ih-km td b{display:block;font-weight:700;color:var(--ink);font-size:14.5px;margin:0 0 5px}\n.sr-ih-screen{display:block}\n.sr-ih-set{font-family:var(--mono);font-size:11.5px;line-height:1.75;color:var(--ink-soft);letter-spacing:.01em}\n.sr-ih-flag{display:inline-block;font-family:var(--mono);font-size:9.5px;letter-spacing:.11em;text-transform:uppercase;color:var(--sub-line);border:1px solid var(--sub-soft);background:#fdf8ef;border-radius:2px;padding:2px 6px;margin:0 0 6px;font-weight:600}\n.sr-ih-2026 p.sr-table-note{font-family:var(--mono);font-size:11.5px;line-height:1.7;color:var(--ink-soft);margin:10px 0 0;max-width:84ch}\n.sr-ih-tx{border:1px solid var(--rule);border-radius:4px;margin:22px 0 0;background:#fff}\n.sr-ih-tx>summary{font-family:var(--mono);font-size:12px;letter-spacing:.14em;text-transform:uppercase;color:var(--ink-soft);font-weight:600;padding:16px 22px;cursor:pointer;list-style:none;display:flex;align-items:center;justify-content:space-between;gap:14px;background:var(--panel);border-radius:4px}\n.sr-ih-tx[open]>summary{border-bottom:1px solid var(--rule);border-radius:4px 4px 0 0}\n.sr-ih-tx>summary::-webkit-details-marker{display:none}\n.sr-ih-tx>summary:after{content:\"Collapse\";font-size:10.5px;letter-spacing:.1em;color:#637274;font-weight:400}\n.sr-ih-tx:not([open])>summary:after{content:\"Read the transcript\"}\n.sr-ih-txbody{padding:26px 30px 8px}\n.sr-ih-txsec{border-top:1px solid var(--rule-soft);padding-top:20px;margin-top:26px}\n.sr-ih-txsec:first-of-type{border-top:0;padding-top:0;margin-top:0}\n.sr-ih-txwin{font-family:var(--mono)!important;font-size:10.5px!important;letter-spacing:.15em;text-transform:uppercase;color:var(--sub-line);font-weight:600!important;margin:0 0 12px!important}\n@media (min-width:1000px){.sr-ih-txnote span{max-width:74ch;margin-left:188px}.sr-ih-txsec{display:grid;grid-template-columns:158px minmax(0,1fr);gap:0 30px;align-items:start}.sr-ih-txsec br,.sr-ih-txsec>p:empty{display:none}.sr-ih-txwin{margin:5px 0 0!important;text-align:right}.sr-ih-txcol{max-width:74ch}}\n.sr-ih-2026 p.sr-ih-txp{font-size:17.5px;line-height:1.72;color:var(--ink-soft);max-width:74ch;margin:0 0 18px}\n.sr-ih-2026 a.sr-ih-txt{font-family:var(--mono);font-size:11.5px;font-variant-numeric:tabular-nums;color:#2a706c!important;text-decoration:none;background:var(--flat-soft);border-radius:2px;padding:2px 6px;margin-right:10px;letter-spacing:.02em;white-space:nowrap;font-weight:600}\n.sr-ih-2026 a.sr-ih-txt:hover{background:#215c58;color:#fff!important}\n.sr-ih-2026 p.sr-ih-txnote{font-family:var(--mono);font-size:11.5px;line-height:1.7;color:var(--ink-soft);margin:0 0 24px;padding:0 0 20px;border-bottom:1px solid var(--rule-soft);max-width:none}\n.sr-ih-txnote span{display:block;max-width:84ch}\n.sr-ih-dev{border:1px solid var(--rule);border-radius:4px;overflow:hidden;margin:22px 0 0}\n.sr-ih-dev__grid{display:grid;grid-template-columns:1fr 1fr}\n.sr-ih-dev__grid br,.sr-ih-dev__grid>p:empty{display:none}\n.sr-ih-dev__col{padding:26px 28px}\n.sr-ih-dev__col+.sr-ih-dev__col{border-left:1px solid var(--rule);background:var(--panel)}\n.sr-ih-2026 p.sr-ih-dev__h{font-family:var(--mono);font-size:10.5px;letter-spacing:.14em;text-transform:uppercase;color:#637274;font-weight:600;margin:0 0 16px}\n.sr-ih-2026 p.sr-ih-dev__name{font-family:var(--sans);font-weight:800;font-size:21px;letter-spacing:-.015em;color:var(--ink);margin:0 0 4px}\n.sr-ih-2026 p.sr-ih-dev__price{font-family:var(--mono);font-size:12.5px;color:var(--sub-line);margin:0 0 18px;letter-spacing:.03em}\n.sr-ih-spec{list-style:none;margin:0;padding:0;font-family:var(--mono);font-size:12px;line-height:1.6;color:var(--ink-soft)}\n.sr-ih-spec li{display:grid;grid-template-columns:96px 1fr;gap:14px;padding:8px 0;border-top:1px solid var(--rule-soft)}\n.sr-ih-spec li:first-child{border-top:0}\n.sr-ih-spec b{color:#637274;font-weight:600;font-size:10.5px;letter-spacing:.09em;text-transform:uppercase;padding-top:1px}\n.sr-ih-spec span{font-variant-numeric:tabular-nums}\n.sr-ih-dev__links{display:flex;flex-wrap:wrap;gap:10px 14px;padding:18px 28px;border-top:1px solid var(--rule);background:#fff;font-family:var(--mono);font-size:12px}\n.sr-ih-dev__links br,.sr-ih-dev__links>p:empty{display:none}\n.sr-ih-2026 .sr-ih-dev__links a{text-decoration:none;border:1px solid var(--rule);border-radius:3px;padding:9px 14px;color:var(--flat)!important;letter-spacing:.03em;transition:border-color .2s ease,background .2s ease}\n.sr-ih-2026 .sr-ih-dev__links a:hover{border-color:var(--flat);background:#eef6f4;color:#2a706c!important}\n.sr-ih-rels{display:grid;grid-template-columns:repeat(3,1fr);gap:22px;margin:22px 0 0}\n.sr-ih-rels br,.sr-ih-rels>p:empty{display:none}\n.sr-ih-2026 .sr-ih-rel{display:block;text-decoration:none!important;color:inherit!important;border:1px solid var(--rule);border-radius:4px;overflow:hidden;font-weight:400!important;transition:border-color .25s ease,transform .25s cubic-bezier(.2,.8,.25,1),box-shadow .25s ease}\n.sr-ih-2026 .sr-ih-rel:hover{border-color:var(--ink-faint);transform:translateY(-2px);box-shadow:0 12px 26px -16px rgba(27,36,38,.5)}\n.sr-ih-rel__img{display:block;position:relative;aspect-ratio:16\/9;background:#04060a}\n.sr-ih-rel__img img{width:100%;height:100%;object-fit:cover;display:block}\n.sr-ih-rel__len{position:absolute;right:8px;bottom:8px;font-family:var(--mono);font-size:10.5px;background:rgba(4,6,10,.86);color:#e8eeec;padding:3px 7px;border-radius:2px;font-variant-numeric:tabular-nums}\n.sr-ih-rel__b{display:block;padding:16px 18px 18px}\n.sr-ih-rel__t{display:block;font-family:var(--sans);font-weight:700;font-size:15.5px;line-height:1.3;color:var(--ink);margin:0 0 7px;letter-spacing:-.01em}\n.sr-ih-rel__d{display:block;font-size:14.5px;line-height:1.55;color:var(--ink-soft);margin:0 0 12px}\n.sr-ih-rel__cta{display:block;font-family:var(--mono);font-size:11px;letter-spacing:.1em;text-transform:uppercase;color:var(--flat);font-weight:600}\n.sr-ih-2026 p.sr-ih-hublink{font-family:var(--mono);font-size:12px;color:var(--ink-soft);margin:18px 0 0;max-width:84ch}\n.sr-ih-q{border-bottom:1px solid var(--rule-soft);padding:0}\n.sr-ih-q:first-of-type{border-top:1px solid var(--rule-soft)}\n.sr-ih-q>summary{font-family:var(--sans);font-weight:700;font-size:17px;color:var(--ink);padding:18px 34px 18px 0;cursor:pointer;list-style:none;position:relative;line-height:1.35}\n.sr-ih-q>summary::-webkit-details-marker{display:none}\n.sr-ih-q>summary:after{content:\"\";position:absolute;right:8px;top:50%;width:9px;height:9px;border-right:1.5px solid var(--ink-faint);border-bottom:1.5px solid var(--ink-faint);transform:translateY(-70%) rotate(45deg);transition:transform .25s ease}\n.sr-ih-q[open]>summary:after{transform:translateY(-30%) rotate(225deg)}\n.sr-ih-q p{margin:0 0 12px;color:var(--ink-soft);font-size:17px;max-width:75ch}\n.sr-ih-cite{display:block;font-family:var(--mono);font-size:11px;color:var(--ink-soft);line-height:1.7;padding:0 0 20px;max-width:80ch}\n.sr-ih-src{list-style:none;margin:22px 0 0;padding:0;font-family:var(--mono);font-size:12px;line-height:1.7}\n.sr-ih-src li{padding:14px 0;border-top:1px solid var(--rule-soft)}\n.sr-ih-src li span{display:block;color:var(--ink-soft);margin-top:4px;max-width:88ch}\n.sr-final-cta{background:var(--ink);color:#eef2f1;border-radius:4px;padding:38px 34px 34px;margin:52px 0 0;display:grid;grid-template-columns:minmax(0,1fr) 300px;gap:34px;align-items:center}\n.sr-final-cta br,.sr-final-cta>p:empty{display:none}\n.sr-final-cta h2{color:#fff!important;margin:0 0 12px!important;font-size:clamp(22px,3vw,29px)!important}\n.sr-ih-2026 .sr-final-cta p{color:#a9b8b6;font-size:16.5px;line-height:1.6;margin:0;max-width:56ch}\n.sr-chat-link{display:block}\n.sr-crisp-consult-btn{position:relative;display:inline-flex;align-items:center;justify-content:center;gap:9px;width:100%;min-height:48px;border:0;border-radius:4px;background:linear-gradient(135deg,#39e889 0%,#22c55e 52%,#00c853 100%);color:#fff;font-family:var(--mono);font-size:12px;font-weight:700;letter-spacing:.04em;line-height:1.1;padding:13px 16px;box-shadow:0 8px 18px rgba(34,197,94,.24);animation:srIhBreath 2.65s ease-in-out infinite;cursor:pointer}\n.sr-crisp-consult-btn:before{content:\"\";width:8px;height:8px;border-radius:999px;background:#ecfff3;box-shadow:0 0 0 0 rgba(236,255,243,.78),0 0 9px rgba(236,255,243,.86);animation:srIhDotPulse 1.8s ease-out infinite}\n@keyframes srIhBreath{0%,100%{transform:translateY(0);box-shadow:0 8px 18px rgba(34,197,94,.24),0 0 0 0 rgba(34,197,94,.2)}50%{transform:translateY(-1px);box-shadow:0 12px 24px rgba(34,197,94,.34),0 0 0 7px rgba(34,197,94,.08)}}\n@keyframes srIhDotPulse{0%{box-shadow:0 0 0 0 rgba(236,255,243,.76),0 0 9px rgba(236,255,243,.85)}70%{box-shadow:0 0 0 8px rgba(236,255,243,0),0 0 12px rgba(236,255,243,.65)}100%{box-shadow:0 0 0 0 rgba(236,255,243,0),0 0 9px rgba(236,255,243,.85)}}\n.sr-author-panel{margin:20px 0 0}\n.sr-ih-2026 p.sr-byline__label{margin:0;max-width:none}\n.sr-author-grid{display:grid;grid-template-columns:1fr 1fr;gap:0 30px;margin:10px 0 14px}\n.sr-author-card{border-top:1px solid var(--rule);padding:13px 0 4px;min-width:0}\n.sr-author-card__head{display:flex;align-items:center;gap:11px}\n.sr-author-card__head img{width:42px;height:42px;border-radius:999px;object-fit:cover;border:1px solid var(--rule);background:#fff;flex:0 0 auto}\n.sr-author-card__id{display:flex;flex-direction:column;min-width:0}\n.sr-ih-2026 .sr-author-card__id b{font-family:var(--sans);font-size:15px;font-weight:700;color:var(--ink);letter-spacing:-.006em;line-height:1.2}\n.sr-author-card__role{font-family:var(--mono);font-size:10.5px;letter-spacing:.05em;color:#637274;line-height:1.4;margin-top:3px}\n.sr-ih-2026 .sr-author-card details{margin:9px 0 0}\n.sr-ih-2026 .sr-author-card summary{font-family:var(--mono);font-size:10.5px;letter-spacing:.13em;text-transform:uppercase;color:var(--flat);font-weight:600;cursor:pointer;list-style:none;display:inline-flex;align-items:center;gap:8px;padding:2px 0}\n.sr-ih-2026 .sr-author-card summary::-webkit-details-marker{display:none}\n.sr-ih-2026 .sr-author-card summary:after{content:\"+\";font-family:var(--sans);font-size:13px;line-height:1;color:var(--ink-faint);font-weight:400}\n.sr-ih-2026 .sr-author-card details[open] summary:after{content:\"\u00813\"}\n.sr-ih-2026 .sr-author-card details p{margin:10px 0 0;color:var(--ink-soft);font-size:15px;line-height:1.6;max-width:62ch}\n.sr-ih-2026 p.sr-author-card__links{font-family:var(--mono);font-size:11px;letter-spacing:.03em;margin:10px 0 2px;color:var(--ink-faint);max-width:none}\n.sr-author-meta{display:flex;flex-wrap:wrap;gap:8px 20px;align-items:center;font-family:var(--mono);font-size:12.5px;letter-spacing:.02em;color:var(--ink-soft)}\n.sr-ih-2026 p.sr-author-meta{margin:0;max-width:none}\n.sr-author-meta b{color:var(--ink);font-weight:600}\n.sr-light-toc{display:none;position:fixed;top:140px;left:calc(50% + 640px);width:300px;z-index:20;background:#fff;border:1px solid #d7dedc;border-radius:4px;padding:18px 18px 16px;max-height:calc(100vh - 190px);overflow:auto;font-family:ui-monospace,\"SF Mono\",\"Cascadia Mono\",Menlo,Consolas,monospace}\n.sr-light-toc__head{display:flex;align-items:baseline;justify-content:space-between;gap:10px;margin:0 0 10px}\n.sr-ih-2026 .sr-light-toc__title{font-size:11px;letter-spacing:.18em;text-transform:uppercase;color:#b9791f;margin:0;font-weight:600}\n.sr-ih-2026 .sr-light-toc__progress{font-size:10px;color:#637274;letter-spacing:.06em;font-variant-numeric:tabular-nums}\n.sr-light-toc__links{display:flex;flex-direction:column;counter-reset:toc}\n.sr-ih-2026 .sr-light-toc__links a{counter-increment:toc;display:flex;align-items:baseline;gap:10px;font-size:12px;line-height:1.35;color:#586669!important;text-decoration:none;font-weight:400;padding:6px 8px 6px 10px;border-left:2px solid #e6ebe9}\n.sr-ih-2026 .sr-light-toc__links a:before{content:counter(toc,decimal-leading-zero);font-size:9.5px;color:#637274;letter-spacing:.06em;min-width:18px;flex:0 0 auto}\n.sr-ih-2026 .sr-light-toc__links a:hover{color:#1b2426!important;border-left-color:#c98a2b}\n.sr-ih-2026 .sr-light-toc__links a.sr-toc-active{color:#1b2426!important;border-left-color:#c98a2b;font-weight:600}\n.sr-ih-2026 p.sr-light-toc__note{font-family:Charter,\"Iowan Old Style\",Georgia,serif;font-size:13.5px;line-height:1.5;color:#586669;margin:14px 0 10px;max-width:none}\n@media (min-width:1420px) and (max-width:1919px){body.postid-35935 .wd-content-area.site-content,body.postid-35935 .wd-entry-content{max-width:1180px!important}.sr-ih-2026{max-width:1180px}.sr-light-toc{display:block;left:auto;right:4px;width:114px;padding:12px 7px}.sr-ih-2026 .sr-light-toc__links a{font-size:9.5px;padding:5px 3px}.sr-ih-2026 p.sr-light-toc__note{font-size:11px}.sr-light-toc .sr-crisp-consult-btn{font-size:9px;padding:10px 3px}.sr-ih-2026 .sr-light-toc__progress{font-size:9px}}\n@media (min-width:1920px){.sr-light-toc{display:block}body.postid-35935 .wd-content-area.site-content,body.postid-35935 .wd-entry-content{max-width:1200px!important}.sr-ih-2026{max-width:1200px}}\n@media (max-width:900px){.sr-author-grid{grid-template-columns:1fr;gap:0}.sr-ih-dev__grid{grid-template-columns:1fr}.sr-ih-dev__col+.sr-ih-dev__col{border-left:0;border-top:1px solid var(--rule)}.sr-ih-rels{grid-template-columns:1fr 1fr}.sr-final-cta{grid-template-columns:1fr;gap:24px}.sr-ih-lines{grid-template-columns:1fr}.sr-ih-2026 .sr-ih-line{border-left:0;padding:22px 22px 20px}.sr-ih-2026 .sr-ih-line+.sr-ih-line{border-top:1px solid rgba(255,255,255,.1)}}\n@media (max-width:640px){.sr-ih-2026{font-size:18px;padding:0 0 60px}.sr-byline__author{width:100%;align-items:center;flex-wrap:wrap;gap:6px 10px}.sr-byline b{white-space:nowrap}.sr-byline{gap:12px 18px}.sr-ih-badge__x{display:none}.sr-ih-2026 .sr-ih-line{padding:20px 18px}.sr-ih-seg em{display:none}.sr-ih-seg{padding:7px 4px 8px}.sr-ih-seg b{font-size:9.5px;letter-spacing:0}.sr-ih-mark b{font-size:13px}.sr-ih-tick b{font-size:10px}.sr-ih-scale{margin-bottom:36px}.sr-ih-band{padding:28px 20px 24px}.sr-ih-rels{grid-template-columns:1fr}.sr-ih-txbody{padding:20px 18px 4px}.sr-ih-dev__col{padding:22px 20px}.sr-ih-dev__links{padding:16px 20px}.sr-ih-dev__links a{flex:1 1 auto;text-align:center}#quick-answer{padding:22px 20px 8px}#quick-answer p{font-size:18.5px}.sr-final-cta{padding:28px 20px 26px}.sr-ih-spec li{grid-template-columns:1fr;gap:2px}.sr-ih-line__h{font-size:16px}.sr-ih-play svg{width:62px;height:62px}}\n@media (prefers-reduced-motion:reduce){.sr-ih-2026 *,.sr-light-toc *{animation-duration:.001ms!important;animation-iteration-count:1!important;transition-duration:.001ms!important}}<\/style>\n<div class=\"sr-mast\">\n<p class=\"sr-deck\">A developmental hip screen run end to end on the linear array of a handheld probe &mdash; one coronal image, three construction lines laid on the frozen frame, and two angles read against the table Graf published &mdash; with every step timestamped, the settings read off the device screen, and the whole recording transcribed.<\/p>\n<div class=\"sr-author-panel\" data-suresult-author-panel aria-label=\"Article authors\">\n<p class=\"sr-byline__label\">Written and clinically reviewed by<\/p>\n<div class=\"sr-author-grid\">\n<article class=\"sr-author-card\" data-sr-author=\"fernando-mariz-md\">\n<div class=\"sr-author-card__head\"><img src=\"https:\/\/suresultmed.com\/wp-content\/uploads\/fernando-mariz-md-author-avatar.png\" alt=\"Fernando Mariz, MD\" width=\"42\" height=\"42\" loading=\"lazy\" decoding=\"async\"><span class=\"sr-author-card__id\"><b>Fernando Mariz, MD<\/b><span class=\"sr-author-card__role\">Gynecology, pelvic surgery, sonography<\/span><\/span><\/div>\n<details data-sr-author-bio>\n<summary>About Dr. Mariz<\/summary>\n<p>I am Dr. Fernando Mariz, a gynecology and pelvic surgery physician practicing in New York City. Before my medical career, I served in the U.S. Marine Corps, where I developed the discipline, focus, and steadiness that continue to shape the way I care for patients today. At Maiden Lane Medical, my work covers women&rsquo;s health, preventive care, sonography, pelvic pain, abnormal uterine bleeding, and minimally invasive gynecologic procedures.<\/p>\n<p class=\"sr-author-card__links\"><a href=\"https:\/\/maidenlanemedical.com\/profile\/fernando-mariz-md\/\" target=\"_blank\" rel=\"noopener noreferrer nofollow\">Maiden Lane Medical profile<\/a> &middot; <a href=\"https:\/\/weillcornell.org\/fernando-marizmd-9639\" target=\"_blank\" rel=\"noopener noreferrer nofollow\">Weill Cornell Medicine<\/a><\/p>\n<\/details>\n<\/article>\n<article class=\"sr-author-card\" data-sr-author=\"jailyn-avila-md\">\n<div class=\"sr-author-card__head\"><img src=\"https:\/\/suresultmed.com\/wp-content\/uploads\/jailyn-avila-md-author-avatar.png\" alt=\"Jailyn Avila, MD\" width=\"42\" height=\"42\" loading=\"lazy\" decoding=\"async\"><span class=\"sr-author-card__id\"><b>Jailyn Avila, MD<\/b><span class=\"sr-author-card__role\">Emergency medicine, POCUS education<\/span><\/span><\/div>\n<details data-sr-author-bio>\n<summary>About Dr. Avila<\/summary>\n<p>I am Dr. Jailyn Avila, an emergency medicine physician, educator, and digital health innovator based in Southern California. My clinical work is rooted in emergency care, while my teaching focuses on point-of-care ultrasound, residency education, and practical training for physicians. Through my roles with Emergent Medical Associates, UHS SoCal MEC Emergency Medicine Residency, Core Ultrasound, and FemInEM, I work at the intersection of patient care, medical education, and accessible digital learning.<\/p>\n<p class=\"sr-author-card__links\"><a href=\"https:\/\/jailynavila.com\/\" target=\"_blank\" rel=\"noopener noreferrer nofollow\">Personal site<\/a> &middot; <a href=\"https:\/\/feminem.org\/about\" target=\"_blank\" rel=\"noopener noreferrer nofollow\">FemInEM<\/a><\/p>\n<\/details>\n<\/article>\n<\/div>\n<p class=\"sr-author-meta\"><span class=\"sr-verified-badge\">Verified authors<\/span><span>Updated <b>September 10, 2026<\/b><\/span><\/p>\n<\/div>\n<\/div>\n<figure class=\"sr-ih-stage\">\n<button class=\"sr-ih-player\" id=\"sr-ih-player\" type=\"button\" aria-label=\"Play the 3-minute infant hip Graf method walkthrough\"><br \/>\n<img src=\"https:\/\/suresultmed.com\/wp-content\/uploads\/infant-hip-graf-coronal-landmarks-poster.jpg\" alt=\"Frozen coronal hip image on a Suresult D3Ultra: the straight lateral wall of the ilium, the bony roof of the acetabulum, the labrum and the femoral head, at 60 mm depth and H10.0 MHz\" width=\"1280\" height=\"720\" fetchpriority=\"high\" decoding=\"async\"><br \/>\n<span class=\"sr-ih-play\"><svg viewBox=\"0 0 84 84\" aria-hidden=\"true\" focusable=\"false\"><circle cx=\"42\" cy=\"42\" r=\"40\" fill=\"rgba(10,14,18,.62)\" stroke=\"rgba(255,255,255,.9)\" stroke-width=\"1.6\"\/><path d=\"M34.5 28.2 L58 42 L34.5 55.8 Z\" fill=\"#fff\"\/><\/svg><\/span><br \/>\n<span class=\"sr-ih-badge\"><span>3:06<\/span><span class=\"sr-ih-badge__k\">8 key moments<\/span><span class=\"sr-ih-badge__x\">Transcript below<\/span><\/span><br \/>\n<\/button><figcaption class=\"sr-ih-cap\"><b>Presented by Brandon Ramakko, DC, recorded on a D3Ultra and posted to the Suresult channel on 6 October 2025.<\/b> The infant is five months old. The poster above is the frozen coronal image before any line is drawn; the same frame carries the finished construction further down the page.<\/figcaption><\/figure>\n<section id=\"quick-answer\">\n<h2>Quick answer<\/h2>\n<p><strong>An infant hip ultrasound answers one question &mdash; is the socket deep enough to hold the head &mdash; and the Graf method answers it from a single coronal image with two angles.<\/strong> You lay a baseline down the straight lateral wall of the ilium, drop a second line from it out to the bony rim of the acetabulum, and the angle between them is alpha: 60&deg; or more is a mature Type I hip. A third line runs from the bony rim through the centre of the cartilaginous labrum, and the angle that makes with the same baseline is beta, which should come in under 55&deg;. The hip in this recording reads 71.6&deg; and 48.6&deg;, and the whole measurement takes about forty seconds once the image is frozen. My advice on the order of work is the part people get wrong: do not reach for the calipers until the frozen frame shows a straight iliac line, a visible labral tip and the transition into the triradiate cartilage, because angles measured off a plane that is not the standard plane are precise and meaningless. Jump to 1:31 for the landmarks and 2:07 for the numbers.<\/p>\n<p class=\"sr-answer-note\">Looking for a device rather than the exam? The <a href=\"https:\/\/suresultmed.com\/specialty\/handheld-ultrasound-for-pediatrics\/\">pediatrics hub<\/a> covers the models used for infant and paediatric work, and the <a href=\"https:\/\/suresultmed.com\/shop\/handheld-ultrasounds\/d3ultra-multipurpose-handheld-ultrasound\/\">D3Ultra product page<\/a> carries the full specification and current price.<\/p>\n<\/section>\n<section id=\"construction\">\n<div class=\"sr-ih-band\">\n<p class=\"sr-ih-band__eye\">The construction<\/p>\n<h2>One image, three lines, two numbers<\/h2>\n<p class=\"sr-ih-band__sub\">Everything this exam produces comes off one frozen frame. Three lines go on it in a fixed order, two of them cross the first, and the two angles that result are read against a table published four decades ago and still in use. Click any line to jump the video to the moment it is drawn.<\/p>\n<div class=\"sr-ih-lines\"><a class=\"sr-ih-line\" href=\"#t=104\" data-sr-seek=\"104\"><span class=\"sr-ih-line__n\">01<\/span><span class=\"sr-ih-line__h\">Baseline<\/span><span class=\"sr-ih-line__w\">Along the straight lateral wall of the ilium<\/span><span class=\"sr-ih-line__d\">Drawn first and measured never. Both angles are read against it, so every degree that follows inherits the error in this one line.<\/span><span class=\"sr-ih-line__t\">Drawn at 1:44<\/span><\/a><a class=\"sr-ih-line\" href=\"#t=117\" data-sr-seek=\"117\"><span class=\"sr-ih-line__n\">02<\/span><span class=\"sr-ih-line__h\">Bony roof line<\/span><span class=\"sr-ih-line__w\">Lower limb of the ilium out to the bony rim<\/span><span class=\"sr-ih-line__d\">Its angle to the baseline is alpha. Alpha is a depth measurement in disguise: how far the bony socket has actually come round the head.<\/span><span class=\"sr-ih-line__t\">Drawn at 1:57<\/span><\/a><a class=\"sr-ih-line\" href=\"#t=127\" data-sr-seek=\"127\"><span class=\"sr-ih-line__n\">03<\/span><span class=\"sr-ih-line__h\">Cartilage roof line<\/span><span class=\"sr-ih-line__w\">Bony rim through the centre of the labrum<\/span><span class=\"sr-ih-line__d\">Its angle to the baseline is beta. Beta reads the cartilage the bone has not reached yet, and it rises as the roof is pushed up and out.<\/span><span class=\"sr-ih-line__t\">Drawn at 2:07<\/span><\/a><\/div>\n<div class=\"sr-ih-scales\">\n<p class=\"sr-ih-scales__h\">Where this hip lands on the Graf table, both axes drawn to scale<\/p>\n<p><span class=\"sr-ih-scale\"><span class=\"sr-ih-scale__h\">Alpha \u00b7 the bony roof<\/span><span class=\"sr-ih-track\"><span class=\"sr-ih-seg sr-ih-seg--bad\" style=\"width:19.5652%\"><b>III \/ IV<\/b><em>Dislocated<\/em><\/span><span class=\"sr-ih-seg sr-ih-seg--warn\" style=\"width:15.2174%\"><b>IIc<\/b><em>Critical<\/em><\/span><span class=\"sr-ih-seg sr-ih-seg--mid\" style=\"width:21.7391%\"><b>IIa \/ IIb<\/b><em>Immature to 3 months, delayed after<\/em><\/span><span class=\"sr-ih-seg sr-ih-seg--good\" style=\"width:43.4783%\"><b>I<\/b><em>Mature<\/em><\/span><\/span><span class=\"sr-ih-axis\"><span class=\"sr-ih-tick\" style=\"left:19.5652%\"><i><\/i><b>43<\/b><\/span><span class=\"sr-ih-tick\" style=\"left:34.7826%\"><i><\/i><b>50<\/b><\/span><span class=\"sr-ih-tick\" style=\"left:56.5217%\"><i><\/i><b>60<\/b><\/span><span class=\"sr-ih-mark\" style=\"left:81.7391%\"><i><\/i><b>71.6\u00b0<\/b><em>this hip<\/em><\/span><\/span><\/span><span class=\"sr-ih-scale\"><span class=\"sr-ih-scale__h\">Beta \u00b7 the cartilage roof<\/span><span class=\"sr-ih-track\"><span class=\"sr-ih-seg sr-ih-seg--good\" style=\"width:41.6667%\"><b>Under 55<\/b><em>Cartilage roof where it should be<\/em><\/span><span class=\"sr-ih-seg sr-ih-seg--mid\" style=\"width:36.6667%\"><b>55 to 77<\/b><em>Type II territory<\/em><\/span><span class=\"sr-ih-seg sr-ih-seg--bad\" style=\"width:21.6667%\"><b>Over 77<\/b><em>Decentring<\/em><\/span><\/span><span class=\"sr-ih-axis\"><span class=\"sr-ih-tick\" style=\"left:41.6667%\"><i><\/i><b>55<\/b><\/span><span class=\"sr-ih-tick\" style=\"left:78.3333%\"><i><\/i><b>77<\/b><\/span><span class=\"sr-ih-mark\" style=\"left:31.0000%\"><i><\/i><b>48.6\u00b0<\/b><em>this hip<\/em><\/span><\/span><\/span><\/p>\n<p class=\"sr-ih-scales__note\">Alpha bands after Omero&#287;lu&rsquo;s tabulation of Graf&rsquo;s own classification; the beta threshold of 55&deg; after Kang and Koo. Two details the bands cannot show. The 50&ndash;59&deg; band is the same number with two different names and two different meanings &mdash; Type IIa, physiological immaturity, at three months or younger, and Type IIb, a delay of ossification, after that &mdash; so an alpha angle without an age attached is not yet a reading. And Graf&rsquo;s own table splits the mature Type I at beta 55&deg; into Ia and Ib rather than calling everything above it abnormal, which is why the page states 55&deg; as a threshold to act on and not as a wall.<\/p>\n<\/div>\n<p class=\"sr-ih-band__note\">The societies are more relaxed about the angles than this band might suggest. The ACR&ndash;AIUM&ndash;SPR&ndash;SRU practice parameter defines the examination by its two orthogonal planes &mdash; a coronal view in the standard plane at rest and a transverse view of the flexed hip with and without stress &mdash; and treats measuring the alpha angle as optional validation of what the coronal view already shows. Read the numbers as a way of making the impression checkable and repeatable between operators, which is exactly what they are good for.<\/p>\n<\/div>\n<\/section>\n<section id=\"key-moments\">\n<p class=\"sr-ih-krow\">Timestamped<\/p>\n<h2>Key moments, with the settings<\/h2>\n<p>The third column carries what the device panel actually reported at that moment. The useful thing about this recording is how little of it there is: one depth, one frequency, one gain, set before the probe went down and never touched again. The first three rows are argued to camera against reference material, so no panel is on screen for them.<\/p>\n<div class=\"sr-table-wrap\">\n<table class=\"sr-ih-km\">\n<colgroup>\n<col style=\"width:82px\">\n<col>\n<col style=\"width:274px\"><\/colgroup>\n<thead>\n<tr>\n<th>Time<\/th>\n<th>What is on screen<\/th>\n<th>Array, depth, frequency, output<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr>\n<td class=\"sr-ih-t\"><a href=\"#t=15\" data-sr-seek=\"15\">0:15<\/a><\/td>\n<td><b>What DDH is, and the two tests that look for it<\/b><span class=\"sr-ih-flag\">argued<\/span><span class=\"sr-ih-screen\">The shape problem stated plainly: a socket that forms too shallow lets the femoral head slide out. Then the clinical screen \u2014 Barlow to push the hip out, Ortolani to bring it back, a felt clunk either way \u2014 and the verdict on it, that the pair is specific but not sensitive.<\/span><\/td>\n<td class=\"sr-ih-set\">No device panel on screen \u2014 argued to camera<\/td>\n<\/tr>\n<tr>\n<td class=\"sr-ih-t\"><a href=\"#t=47\" data-sr-seek=\"47\">0:47<\/a><\/td>\n<td><b>The number that justifies scanning at all<\/b><span class=\"sr-ih-flag\">argued<\/span><span class=\"sr-ih-screen\">A PubMed abstract is put up full-frame with one line highlighted: against ultrasonography as the reference standard, clinical examination came out at 28.1% sensitivity and 94.5% specificity. That single figure is the whole argument for imaging a hip that examined normally.<\/span><\/td>\n<td class=\"sr-ih-set\">Reference screenshot \u2014 no live imaging<\/td>\n<\/tr>\n<tr>\n<td class=\"sr-ih-t\"><a href=\"#t=60\" data-sr-seek=\"60\">1:00<\/a><\/td>\n<td><b>What the Graf method actually asks of you<\/b><span class=\"sr-ih-flag\">argued<\/span><span class=\"sr-ih-screen\">One image in the coronal plane, two angles measured on it, both compared to a published table. A figure and an infant-scanning photograph are credited on screen to a pediatric hip and spine review. The claim being made is that this takes under a minute.<\/span><\/td>\n<td class=\"sr-ih-set\">Reference figure \u2014 no live imaging<\/td>\n<\/tr>\n<tr>\n<td class=\"sr-ih-t\"><a href=\"#t=79\" data-sr-seek=\"79\">1:19<\/a><\/td>\n<td><b>Acquiring the coronal image<\/b><span class=\"sr-ih-screen\">The acquisition itself, with the leg held at roughly 90 degrees. One pass, then freeze. The tablet is at working distance rather than to camera, so the parameter panel is not readable through this window.<\/span><\/td>\n<td class=\"sr-ih-set\">Linear array in use \u00b7 panel not legible at this distance<\/td>\n<\/tr>\n<tr>\n<td class=\"sr-ih-t\"><a href=\"#t=91\" data-sr-seek=\"91\">1:31<\/a><\/td>\n<td><b>The four landmarks, named on the frozen frame<\/b><span class=\"sr-ih-screen\">Ilium, labrum, the bony roof of the acetabulum, femoral head \u2014 pointed out in that order on the frozen image. Those are the structures the whole construction hangs off, and the frame is held still long enough to find each one.<\/span><\/td>\n<td class=\"sr-ih-set\">FREEZE \u00b7 D 60 mm \u00b7 F H10.0 MHz \u00b7 GN 105 dB \u00b7 DR 80 \u00b7 MI 0.7 \u00b7 TIS 0.1<\/td>\n<\/tr>\n<tr>\n<td class=\"sr-ih-t\"><a href=\"#t=104\" data-sr-seek=\"104\">1:44<\/a><\/td>\n<td><b>The baseline goes down first<\/b><span class=\"sr-ih-screen\">A line laid along the straight lateral wall of the ilium, and an explicit note that no length is being measured \u2014 the tool reports 33.35 mm and the number is ignored. This line exists only to give both angles something to be measured from.<\/span><\/td>\n<td class=\"sr-ih-set\">FREEZE \u00b7 Meas \u25b8 LENGTH \u00b7 V 3.6.78 \u00b7 cine 45\/45<\/td>\n<\/tr>\n<tr>\n<td class=\"sr-ih-t\"><a href=\"#t=117\" data-sr-seek=\"117\">1:57<\/a><\/td>\n<td><b>Alpha, then the start of beta<\/b><span class=\"sr-ih-screen\">The bony roof line is dropped from the baseline vertex and alpha lands at 71.6\u00b0. The second vertex is then planted for beta and the readout opens at 13.0\u00b0, which is the caliper&#8217;s starting position rather than a measurement.<\/span><\/td>\n<td class=\"sr-ih-set\">FREEZE \u00b7 ANGLE tool active \u00b7 both vertices on the lower limb of the ilium<\/td>\n<\/tr>\n<tr>\n<td class=\"sr-ih-t\"><a href=\"#t=127\" data-sr-seek=\"127\">2:07<\/a><\/td>\n<td><b>The numbers, and the table they are read against<\/b><span class=\"sr-ih-screen\">The beta line is walked out towards the labrum and the readout passes 67.6\u00b0, 14.8\u00b0 and 80.8\u00b0 before settling at 48.6\u00b0. The cut-offs are then stated out loud: alpha above 60, or above 50 under three months of age, and beta below 55. This hip clears both, and the exam ends there.<\/span><\/td>\n<td class=\"sr-ih-set\">FREEZE \u00b7 LENGTH 33.35 mm \u00b7 ANGLE 71.6\u00b0 \u00b7 ANGLE 48.6\u00b0<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/div>\n<p class=\"sr-table-note\">Settings transcribed from the device interface visible in the recording: D is depth, F is transmit frequency with harmonics on, GN is gain, DR dynamic range, MI and TIS the acoustic output indices. The software title bar shows only the version, so the preset in use is not stated here. Timestamps are on the YouTube clock.<\/p>\n<\/section>\n<section id=\"what-it-shows\">\n<p class=\"sr-ih-krow\">Reading the images<\/p>\n<h2>What this scan shows<\/h2>\n<p>The coronal view of an infant hip is a corner. The straight lateral wall of the ilium runs down the image as a bright vertical line, it turns at the lower limb of the ilium, and the bony roof of the acetabulum runs out from that turn towards the surface. Sitting in the corner is the femoral head, still largely cartilage at this age and therefore grey and speckled rather than white and shadowing. The labrum caps the roof as a small triangle at the far edge. Those four structures are the exam, and they are what the presenter names on the frozen frame at 1:31.<\/p>\n<figure class=\"sr-ih-fig\">\n<img src=\"https:\/\/suresultmed.com\/wp-content\/uploads\/infant-hip-graf-iliac-baseline.jpg\" alt=\"Baseline being laid along the straight lateral wall of the ilium on a Suresult D3Ultra, measurement menu open over the frozen coronal hip image at 60 mm depth\" width=\"1280\" height=\"720\" loading=\"lazy\" decoding=\"async\"><figcaption class=\"sr-ih-figcap\"><b>The baseline going down at 1:44.<\/b> Laid along the straight lateral wall of the ilium, before either angle exists. The tool reports 33.35 mm and the length is deliberately ignored &mdash; only the line&rsquo;s direction matters. Linear array &middot; D 60 mm &middot; F H10.0 MHz &middot; GN 105 dB &middot; DR 80 &middot; ENH 0 &middot; Compound OFF.<\/figcaption><\/figure>\n<p>A shallow hip does not announce itself; it simply looks a little too open at that corner, which is precisely why the method converts the impression into two numbers. The plane comes first. A standard-plane image shows a straight iliac line, the tip of the labrum and the transition from the ilium into the triradiate cartilage together in one frame, and if any of the three is missing the angles that follow are measuring the wrong section of a three-dimensional socket. Get the plane, freeze, and the rest is geometry.<\/p>\n<figure class=\"sr-ih-fig\">\n<img src=\"https:\/\/suresultmed.com\/wp-content\/uploads\/infant-hip-graf-alpha-beta-angles.jpg\" alt=\"Graf angles constructed on a Suresult D3Ultra: baseline along the ilium with the bony roof line and the cartilage roof line dropped from it, the device reading ANGLE 71.6 degrees and ANGLE 48.6 degrees\" width=\"1280\" height=\"720\" loading=\"lazy\" decoding=\"async\"><figcaption class=\"sr-ih-figcap\"><b>Both angles on screen at 2:23.<\/b> The finished construction: baseline horizontal along the ilium, the bony roof line dropping away below it and the cartilage roof line rising above, with ANGLE 71.6&deg; and ANGLE 48.6&deg; in the readout. Watch the beta caliper in the video rather than trusting a first reading &mdash; it passes through 67.6&deg;, 14.8&deg; and 80.8&deg; before it settles.<\/figcaption><\/figure>\n<p>Alpha and beta are two views of the same failure. Alpha falls when the bony roof has not come far enough round the head; beta rises when the cartilage roof, having nothing solid under it, is pushed up and out by a head sitting too shallow. That is why a hip in trouble usually moves both numbers in opposite directions at once, and why a single number that sits close to its cut-off is worth re-measuring on a fresh image rather than reported.<\/p>\n<\/section>\n<section id=\"transcript\">\n<p class=\"sr-ih-krow\">Verbatim<\/p>\n<h2>Full transcript<\/h2>\n<details class=\"sr-ih-tx\" id=\"sr-ih-transcript\" data-sr-transcript=\"1\" open>\n<summary>Transcript &mdash; 3:06, 9 passages<\/summary>\n<div class=\"sr-ih-txbody\">\n<p class=\"sr-ih-txnote\"><span>Transcribed from the recording and edited for readability; square brackets mark an editorial clarification, and every timestamp jumps the video.<\/span><\/p>\n<section class=\"sr-ih-txsec\">\n<h3 class=\"sr-ih-txwin\">What DDH is<\/h3>\n<div class=\"sr-ih-txcol\">\n<p class=\"sr-ih-txp\"><a class=\"sr-ih-txt\" href=\"#t=0\" data-sr-seek=\"0\">0:00<\/a>My name is Brandon Ramakko, and today we\u2019re going to be using a Suresult D3 handheld ultrasound unit to evaluate an infant\u2019s hip for hip dysplasia, or developmental dysplasia of the hip, DDH. Now, what this is: the hip joint could be sort of malformed; the joint can be a little too shallow, making it easy for the hip to dislocate.<\/p>\n<\/div>\n<\/section>\n<section class=\"sr-ih-txsec\">\n<h3 class=\"sr-ih-txwin\">Ortolani and Barlow, and why they miss<\/h3>\n<div class=\"sr-ih-txcol\">\n<p class=\"sr-ih-txp\"><a class=\"sr-ih-txt\" href=\"#t=21\" data-sr-seek=\"21\">0:21<\/a>And the clinical test for this is called the Ortolani and Barlow test. There\u2019s two tests: basically you dislocate the hip and relocate the hip, and if you can do it just as easy as that, and you clunk and clunk, well then you know that you have hip dysplasia. So it\u2019s a very specific test, but those tests are not very sensitive \u2014 and in fact that combination of tests may miss two-thirds of hip dysplasia cases.<\/p>\n<\/div>\n<\/section>\n<section class=\"sr-ih-txsec\">\n<h3 class=\"sr-ih-txwin\">Why ultrasound, and the Graf method<\/h3>\n<div class=\"sr-ih-txcol\">\n<p class=\"sr-ih-txp\"><a class=\"sr-ih-txt\" href=\"#t=51\" data-sr-seek=\"51\">0:51<\/a>So what\u2019s considered the best way of evaluating the hip for hip dysplasia is ultrasound. So wouldn\u2019t it be great if we could, you know, with a cheap ultrasound unit, evaluate the hip in less than a minute and have our answer? And that\u2019s what we can do. We\u2019ll be using this and something called the Graf method. We basically take one image in the coronal plane, we measure two angles, and we compare those angles to a chart, and then we have our answer. And it\u2019s as easy as that.<\/p>\n<\/div>\n<\/section>\n<section class=\"sr-ih-txsec\">\n<h3 class=\"sr-ih-txwin\">Acquiring the image<\/h3>\n<div class=\"sr-ih-txcol\">\n<p class=\"sr-ih-txp\"><a class=\"sr-ih-txt\" href=\"#t=79\" data-sr-seek=\"79\">1:19<\/a>I have a baby here, and we\u2019re going to take a coronal plane image with the leg at about 90 degrees. And here we go.<\/p>\n<\/div>\n<\/section>\n<section class=\"sr-ih-txsec\">\n<h3 class=\"sr-ih-txwin\">Landmarks, lines and angles<\/h3>\n<div class=\"sr-ih-txcol\">\n<p class=\"sr-ih-txp\"><a class=\"sr-ih-txt\" href=\"#t=91\" data-sr-seek=\"91\">1:31<\/a>And that\u2019s the image we want. We have the ilium here, we have the labrum here, we have the roof of the acetabulum here, we have our femoral head here.<\/p>\n<p class=\"sr-ih-txp\"><a class=\"sr-ih-txt\" href=\"#t=104\" data-sr-seek=\"104\">1:44<\/a>And I\u2019m actually going to start with putting down a line. I don\u2019t actually want to measure any lengths here, but this is basically the line we need to measure from for our angles.<\/p>\n<p class=\"sr-ih-txp\"><a class=\"sr-ih-txt\" href=\"#t=117\" data-sr-seek=\"117\">1:57<\/a>And now I have two angles I need to get: our alpha and our beta. So there\u2019s our alpha, and we need a second angle for our beta.<\/p>\n<\/div>\n<\/section>\n<section class=\"sr-ih-txsec\">\n<h3 class=\"sr-ih-txwin\">The numbers<\/h3>\n<div class=\"sr-ih-txcol\">\n<p class=\"sr-ih-txp\"><a class=\"sr-ih-txt\" href=\"#t=127\" data-sr-seek=\"127\">2:07<\/a>Our alpha in this case is 71.6, and that needs to be larger than 60 \u2014 [larger than 60] is normal. If they\u2019re less than three months old, then it needs to be larger than 50. And for our beta angle, we want our beta angle to be less than 55. So for my baby: it\u2019s larger than 60, because it\u2019s 71.6, and it\u2019s less than 55, because it\u2019s 48.6. So my baby is fine, which is great. And that\u2019s it. It\u2019s as simple as that.<\/p>\n<p class=\"sr-ih-txp\"><a class=\"sr-ih-txt\" href=\"#t=163\" data-sr-seek=\"163\">2:43<\/a>[Sponsor segment omitted, 2:43\u20133:06.]<\/p>\n<\/div>\n<\/section>\n<\/div>\n<\/details>\n<\/section>\n<section id=\"device\" class=\"sr-choice\">\n<p class=\"sr-ih-krow\">Hardware<\/p>\n<h2>Device and settings<\/h2>\n<p>One array, one setting, the whole exam. The left column is the published specification; the right column is what the interface actually reported while this hip was being scanned, and the right column is the one to copy if you are reproducing it &mdash; with two changes I would make. An infant acetabulum sits inside the top 30 mm, so a 60 mm field spends half its pixels on tissue nobody reads; drop to 40 mm and the corner gets twice the screen. And 10 MHz is the ceiling on this linear array, which is enough for the iliac line and the bony rim but thin at the labral tip, the one structure beta depends on. A general-purpose head is not a good fit if infant hips are a weekly fixture rather than an occasional one &mdash; that is a dedicated high-frequency linear purchase.<\/p>\n<div class=\"sr-ih-dev\">\n<div class=\"sr-ih-dev__grid\">\n<div class=\"sr-ih-dev__col\" data-sr-spec-table=\"1\">\n<p class=\"sr-ih-dev__h\">Published specification<\/p>\n<p class=\"sr-ih-dev__name\">Suresult D3Ultra<\/p>\n<p class=\"sr-ih-dev__price\">One head, three arrays &mdash; {{SRX_PRICE:28571}}<\/p>\n<ul class=\"sr-ih-spec\">\n<li><b>Linear<\/b><span>7.5 \/ 10 MHz &middot; 20 \/ 40 \/ 60 \/ 100 mm &middot; 40 mm<\/span><\/li>\n<li><b>Convex<\/b><span>3.2 \/ 5.0 MHz &middot; 90&ndash;300 mm &middot; 45&deg;<\/span><\/li>\n<li><b>Phased<\/b><span>3.2 \/ 5.0 MHz &middot; 90&ndash;300 mm &middot; 60&deg;<\/span><\/li>\n<li><b>Imaging<\/b><span>B, M, Colour, Power and PW Doppler<\/span><\/li>\n<li><b>Beamformer<\/b><span>192 elements &middot; 64 channels &middot; 256 grey levels<\/span><\/li>\n<li><b>Ranges<\/b><span>Gain 30&ndash;105 dB &middot; dynamic range 40&ndash;110<\/span><\/li>\n<li><b>Measurement<\/b><span>Length, area, circumference, angle, trace<\/span><\/li>\n<li><b>Power<\/b><span>2,800 mAh &middot; 2 h scanning &middot; wireless charging<\/span><\/li>\n<li><b>Handset<\/b><span>156 &times; 65 &times; 20 mm &middot; 263 g<\/span><\/li>\n<li><b>Connects to<\/b><span>iOS, Android, Windows &middot; dual-band Wi-Fi<\/span><\/li>\n<\/ul>\n<\/div>\n<div class=\"sr-ih-dev__col\">\n<p class=\"sr-ih-dev__h\">Read off the screen in this recording<\/p>\n<ul class=\"sr-ih-spec\">\n<li><b>Array<\/b><span>Linear &middot; rectangular field, unchanged throughout<\/span><\/li>\n<li><b>Depth<\/b><span>D 60 mm &middot; deeper than an infant acetabulum asks for<\/span><\/li>\n<li><b>Frequency<\/b><span>F H10.0 MHz, harmonic &middot; the ceiling on this array<\/span><\/li>\n<li><b>Gain<\/b><span>GN 105 dB &middot; wide open<\/span><\/li>\n<li><b>Dynamic range<\/b><span>DR 80 &middot; mid-scale of the published span<\/span><\/li>\n<li><b>Processing<\/b><span>ENH 0 &middot; Compound OFF &middot; no speckle reduction<\/span><\/li>\n<li><b>Output<\/b><span>MI 0.7 &middot; TIS 0.1<\/span><\/li>\n<li><b>Mode<\/b><span>B only &middot; no M-mode, no Doppler on this exam<\/span><\/li>\n<li><b>Software<\/b><span>V 3.6.78 &middot; cine buffer 45\/45 on freeze<\/span><\/li>\n<li><b>Tools used<\/b><span>LENGTH for the baseline, then ANGLE twice<\/span><\/li>\n<\/ul>\n<\/div>\n<\/div>\n<div class=\"sr-ih-dev__links\"><a href=\"https:\/\/suresultmed.com\/shop\/handheld-ultrasounds\/d3ultra-multipurpose-handheld-ultrasound\/\">D3Ultra specification and price &rarr;<\/a><a href=\"https:\/\/suresultmed.com\/specialty\/handheld-ultrasound-for-pediatrics\/\">Pediatrics hub &rarr;<\/a><a href=\"https:\/\/suresultmed.com\/suresult-video-library\/\">Scan Library &rarr;<\/a><\/div>\n<\/div>\n<\/section>\n<section id=\"related\">\n<p class=\"sr-ih-krow\">Same probe, other windows<\/p>\n<h2>Related scans<\/h2>\n<div class=\"sr-ih-rels\"><a class=\"sr-ih-rel\" href=\"https:\/\/suresultmed.com\/carpal-tunnel-ultrasound-median-nerve\/\"><span class=\"sr-ih-rel__img\"><img decoding=\"async\" src=\"https:\/\/suresultmed.com\/wp-content\/uploads\/carpal-tunnel-median-nerve-anisotropy-poster.jpg\" alt=\"Transverse ultrasound of the anterior wrist on a handheld probe, median nerve among the flexor tendons\" width=\"640\" height=\"360\" loading=\"lazy\"><span class=\"sr-ih-rel__len\">5:27<\/span><\/span><span class=\"sr-ih-rel__b\"><span class=\"sr-ih-rel__t\">Median nerve at the wrist, measured the same way<\/span><span class=\"sr-ih-rel__d\">The other exam on this device that lives or dies on one number taken off a frozen frame \u2014 anisotropy to find the nerve, then a cross-sectional area.<\/span><span class=\"sr-ih-rel__cta\">Read the walkthrough &rarr;<\/span><\/span><\/a><a class=\"sr-ih-rel\" href=\"https:\/\/suresultmed.com\/rib-fracture-ultrasound-pocus\/\"><span class=\"sr-ih-rel__img\"><img decoding=\"async\" src=\"https:\/\/suresultmed.com\/wp-content\/uploads\/efast-related-rib-fracture.jpg\" alt=\"Rib scanned in long axis on a handheld linear probe, the bright cortical line running across the field\" width=\"640\" height=\"360\" loading=\"lazy\"><span class=\"sr-ih-rel__len\">6:42<\/span><\/span><span class=\"sr-ih-rel__b\"><span class=\"sr-ih-rel__t\">Rib fracture: following a cortical line<\/span><span class=\"sr-ih-rel__d\">Bone surface work on the same linear array, where the whole skill is knowing exactly what an unbroken bright rail looks like at 10 MHz.<\/span><span class=\"sr-ih-rel__cta\">Read the walkthrough &rarr;<\/span><\/span><\/a><a class=\"sr-ih-rel\" href=\"https:\/\/suresultmed.com\/efast-exam-handheld-ultrasound\/\"><span class=\"sr-ih-rel__img\"><img decoding=\"async\" src=\"https:\/\/suresultmed.com\/wp-content\/uploads\/efast-exam-right-upper-quadrant-poster.jpg\" alt=\"Right upper quadrant scan on a handheld probe: liver and right kidney with the hepatorenal recess between them\" width=\"640\" height=\"360\" loading=\"lazy\"><span class=\"sr-ih-rel__len\">14:09<\/span><\/span><span class=\"sr-ih-rel__b\"><span class=\"sr-ih-rel__t\">eFAST trauma exam on the same probe<\/span><span class=\"sr-ih-rel__d\">The long one. Pericardium, both upper quadrants, the pelvis and both lungs, scanned in a single pass with the convex and phased arrays.<\/span><span class=\"sr-ih-rel__cta\">Read the walkthrough &rarr;<\/span><\/span><\/a><\/div>\n<p class=\"sr-ih-hublink\">All the clinical clips, filterable by anatomy and probe, are in the <a href=\"https:\/\/suresultmed.com\/suresult-video-library\/\">Scan Library<\/a>.<\/p>\n<\/section>\n<section id=\"faq\">\n<p class=\"sr-ih-krow\">Asked on this search<\/p>\n<h2>Infant hip questions<\/h2>\n<div class=\"sr-faq sr-ih-faq\">\n<details class=\"sr-ih-q\" open>\n<summary>At what age is an infant hip ultrasound done?<\/summary>\n<p>From about six weeks of age. The ACR\u2013AIUM\u2013SPR\u2013SRU practice parameter states that because of physiologic laxity, hip sonography is usually not performed on patients younger than 6 weeks unless an abnormal physical finding calls for it, and that radiography is preferable from 6 months of age onward. The infant scanned in the recording above is five months old, inside that window at both ends. My own rule is to treat a very early scan as a question rather than an answer: laxity that would have resolved on its own reads as instability, and a separate 2022 review puts the false-positive risk specifically in the first four weeks.<\/p>\n<p><span class=\"sr-ih-cite\">Source: <a href=\"https:\/\/gravitas.acr.org\/PPTS\/DownloadPreviewDocument?DocId=27\" rel=\"nofollow noopener\" target=\"_blank\">Practice parameter for the ultrasound examination for detection and assessment of DDH<\/a>. Accessed September 10, 2026.<\/span><\/details>\n<details class=\"sr-ih-q\">\n<summary>What is a normal alpha angle on an infant hip ultrasound?<\/summary>\n<p>Sixty degrees or more. In the Graf classification an alpha angle of 60\u00b0 or above is a Type I mature hip. Between 50\u00b0 and 59\u00b0 the reading depends entirely on age: at three months or younger it is Type IIa, physiological immaturity; the same 50\u201359\u00b0 after three months is Type IIb, a delay of ossification. Below that, 43\u201349\u00b0 is Type IIc and anything under 43\u00b0 is Type III or IV. The hip measured in the recording reads 71.6\u00b0, which sits well inside Type I.<\/p>\n<p><span class=\"sr-ih-cite\">Source: <a href=\"https:\/\/pmc.ncbi.nlm.nih.gov\/articles\/PMC3965765\/\" rel=\"nofollow noopener\" target=\"_blank\">Use of ultrasonography in developmental dysplasia of the hip<\/a>. Accessed September 10, 2026.<\/span><\/details>\n<details class=\"sr-ih-q\">\n<summary>What does the beta angle add that alpha does not?<\/summary>\n<p>Alpha reads the bone; beta reads the cartilage the bone has not reached yet. Both are measured from the same baseline along the straight lateral wall of the ilium. Alpha is the angle out to the bony rim of the acetabulum, so it describes how deep the bony socket has become. Beta is the angle out through the centre of the cartilaginous labrum, so it describes how far the cartilage roof has been pushed up and outward by a head that is not seated deeply enough. Kang and Koo put the abnormal threshold at greater than 55\u00b0. The hip in the recording reads 48.6\u00b0.<\/p>\n<p><span class=\"sr-ih-cite\">Source: <a href=\"https:\/\/europepmc.org\/article\/MED\/28372341\" rel=\"nofollow noopener\" target=\"_blank\">Ultrasonography of the pediatric hip and spine<\/a>. Accessed September 10, 2026.<\/span><\/details>\n<details class=\"sr-ih-q\">\n<summary>How much does the clinical examination miss on its own?<\/summary>\n<p>Enough that a normal Barlow and Ortolani is not an all-clear. Barlow dislocates the hip, Ortolani relocates it, and a felt clunk on either is the positive finding \u2014 a click is not. In a series of 5,701 newborns screened both ways, with Graf-method ultrasound as the reference standard, clinical examination came out 28.1% sensitive and 94.5% specific: 240 of the 334 hips that ultrasound graded Graf IIb or worse were read as normal on examination. A separate review puts the physical exam at 37% sensitive for frank dislocation. Different studies and different denominators, and they point the same way \u2014 the examination is good at confirming and poor at excluding.<\/p>\n<p><span class=\"sr-ih-cite\">Source: <a href=\"https:\/\/pmc.ncbi.nlm.nih.gov\/articles\/PMC3908525\/\" rel=\"nofollow noopener\" target=\"_blank\">Comparing results of clinical versus ultrasonographic examination in DDH<\/a>. Accessed September 10, 2026.<\/span><\/details>\n<details class=\"sr-ih-q\">\n<summary>Can this scan be done on a general-purpose handheld probe?<\/summary>\n<p>It is, in the recording above, on the linear array of a D3Ultra at 10 MHz, and all three standard-plane landmarks stay legible. Two things I would set differently. The depth is left at 60 mm when the acetabulum sits inside the top 30, so half the field is spent on tissue nobody is reading and the anatomy is drawn smaller than it needs to be. And 10 MHz is the ceiling on that array: a dedicated 12 to 18 MHz linear head resolves the tip of the labrum more crisply, and the labral tip is the structure the beta angle hangs on. Neither point stops you taking the angles. Both make them easier to defend.<\/p>\n<p><span class=\"sr-ih-cite\">Source: <a href=\"https:\/\/suresultmed.com\/shop\/handheld-ultrasounds\/d3ultra-multipurpose-handheld-ultrasound\/\" rel=\"nofollow noopener\" target=\"_blank\">Suresult D3Ultra product page<\/a>. Accessed September 10, 2026.<\/span><\/details>\n<\/div>\n<\/section>\n<section id=\"sources\">\n<p class=\"sr-ih-krow\">Provenance<\/p>\n<h2>Sources<\/h2>\n<ul class=\"sr-ih-src\">\n<li><a href=\"https:\/\/pmc.ncbi.nlm.nih.gov\/articles\/PMC3965765\/\" rel=\"nofollow noopener\" target=\"_blank\">Use of ultrasonography in developmental dysplasia of the hip<\/a><span>Omero\u011flu, H. Journal of Children\u2019s Orthopaedics, 2014;8(2):105\u2013113. Table 1 tabulates the hip types of the Graf method directly from Graf\u2019s own 2006 text, and is the source of the alpha bands and the Type IIa \/ IIb age split used on this page. Accessed September 10, 2026.<\/span><\/li>\n<li><a href=\"https:\/\/europepmc.org\/article\/MED\/28372341\" rel=\"nofollow noopener\" target=\"_blank\">Ultrasonography of the pediatric hip and spine<\/a><span>Kang, Y. R. and Koo, J. Ultrasonography, 2017;36(3):239\u2013251. The review shown on screen in the recording at 1:00. Source of the three standard-plane landmarks, of the definitions of the baseline, bony roof line and cartilage roof line, and of the beta threshold of 55\u00b0 quoted on this page. Accessed September 10, 2026.<\/span><\/li>\n<li><a href=\"https:\/\/gravitas.acr.org\/PPTS\/DownloadPreviewDocument?DocId=27\" rel=\"nofollow noopener\" target=\"_blank\">Practice parameter for the ultrasound examination for detection and assessment of DDH<\/a><span>ACR\u2013AIUM\u2013SPR\u2013SRU, revised 2023 (Resolution 34). Source of the six-week timing, of the preference for radiography from six months, and of the standard-plane definition. It also treats angle measurement as optional validation rather than as the examination itself. Accessed September 10, 2026.<\/span><\/li>\n<li><a href=\"https:\/\/pmc.ncbi.nlm.nih.gov\/articles\/PMC3908525\/\" rel=\"nofollow noopener\" target=\"_blank\">Comparing results of clinical versus ultrasonographic examination in DDH<\/a><span>Arti, H., Mehdinasab, S. A. and Arti, S. Journal of Research in Medical Sciences, 2013;18(12):1051\u20131055. The abstract displayed full-frame in the recording at 0:47. 5,701 newborns and 11,402 hips; clinical examination 28.1% sensitive and 94.5% specific against Graf-method ultrasound. Accessed September 10, 2026.<\/span><\/li>\n<li><a href=\"https:\/\/pmc.ncbi.nlm.nih.gov\/articles\/PMC9789252\/\" rel=\"nofollow noopener\" target=\"_blank\">Common ultrasound applications for pediatric musculoskeletal conditions<\/a><span>de Borja, C., Watkins, R. and Woolridge, T. Current Reviews in Musculoskeletal Medicine, 2022;15(6):447\u2013455. Source of the 37% sensitivity of the physical examination for hip dislocation and of the first-four-weeks false-positive caution. Accessed September 10, 2026.<\/span><\/li>\n<li><a href=\"https:\/\/pmc.ncbi.nlm.nih.gov\/articles\/PMC8305660\/\" rel=\"nofollow noopener\" target=\"_blank\">Current evidence about developmental dysplasia of the hip in pregnancy<\/a><span>Simionescu, A. A. et al. Medicina, 2021;57(7):655. Source of the Barlow-dislocates \/ Ortolani-relocates definitions used on this page, and of the distinction between a felt clunk and a click. Accessed September 10, 2026.<\/span><\/li>\n<li><a href=\"https:\/\/suresultmed.com\/shop\/handheld-ultrasounds\/d3ultra-multipurpose-handheld-ultrasound\/\" rel=\"nofollow noopener\" target=\"_blank\">Suresult D3Ultra product page<\/a><span>The published attribute table: array frequencies and their depth ranges, aperture and scan angles, element and channel counts, grey levels, gain and dynamic-range spans, battery, dimensions and weight. Accessed September 10, 2026.<\/span><\/li>\n<li><a href=\"https:\/\/www.drramakko.com\/\" rel=\"nofollow noopener\" target=\"_blank\">Dr. Brandon Ramakko<\/a><span>The presenting clinician\u2019s own site, and the basis for how his role is described here: a neuromusculoskeletal medicine specialist who uses diagnostic ultrasound routinely and teaches musculoskeletal point-of-care scanning. Accessed September 10, 2026.<\/span><\/li>\n<li><a href=\"https:\/\/www.youtube.com\/watch?v=NOCCenryxPg\" rel=\"nofollow noopener\" target=\"_blank\">Suresult channel \u2014 the recording on this page<\/a><span>\u201cPOCUS for DDH (Graf Method) Using Suresult D3Ultra\u201d, published 6 October 2025, 3:06. The transcript, the key moments and every scan frame on this page come from it. Accessed September 10, 2026.<\/span><\/li>\n<\/ul>\n<\/section>\n<div class=\"sr-final-cta\">\n<div>\n<h2>Which array does your paediatric work actually need?<\/h2>\n<p>An infant hip wants a high-frequency linear head and barely any depth. The abdominal and chest questions that arrive in the same clinic want the opposite. A three-in-one head answers both from one device; a dedicated pair answers both better, for more money. Tell us the setting and the case mix and you will get a direct recommendation in one conversation &mdash; one probe, two, or neither.<\/p>\n<\/div>\n<div class=\"sr-chat-link\">\n<button class=\"sr-crisp-consult-btn\" type=\"button\" data-sr-crisp-open onclick=\"window.$crisp=window.$crisp||[];window.$crisp.push(['do','chat:open']);\">ONLINE EXPERT CONSULT<\/button>\n<\/div>\n<\/div>\n<nav id=\"sr-ih-toc\" class=\"sr-light-toc sr-sticky-toc sr-article-toc\" data-suresult-toc data-sr-hide-on-wide-table aria-label=\"Infant hip walkthrough navigation\">\n<div class=\"sr-light-toc__head\">\n<div class=\"sr-light-toc__title\">On this page<\/div>\n<p><span class=\"sr-light-toc__progress\" id=\"sr-ih-progress\">0%<\/span><\/div>\n<div class=\"sr-light-toc__links\"><a href=\"#quick-answer\">Quick answer<\/a><a href=\"#construction\">The construction<\/a><a href=\"#key-moments\">Key moments<\/a><a href=\"#what-it-shows\">What this scan shows<\/a><a href=\"#transcript\">Full transcript<\/a><a href=\"#device\">Device and settings<\/a><a href=\"#related\">Related scans<\/a><a href=\"#faq\">Infant hip questions<\/a><a href=\"#sources\">Sources<\/a><\/div>\n<p class=\"sr-light-toc__note\">Not sure which array your paediatric work needs?<\/p>\n<p><button class=\"sr-crisp-consult-btn\" type=\"button\" data-sr-crisp-open onclick=\"window.$crisp=window.$crisp||[];window.$crisp.push(['do','chat:open']);\">ONLINE EXPERT CONSULT<\/button><br \/>\n<\/nav>\n<\/div>\n<p><script>(function(){\nvar AMP=String.fromCharCode(38);\nvar VID='NOCCenryxPg';\nfunction embed(start){\nvar u='https:\/\/www.youtube-nocookie.com\/embed\/'+VID+'?rel=0'+AMP+'autoplay=1';\nif(start){u=u+AMP+'start='+start;}\nreturn u;\n}\nfunction mount(start){\nvar pl=document.getElementById('sr-ih-player');\nif(!pl){return null;}\nif(pl.classList.contains('is-live')){\nvar fr=pl.querySelector('iframe');\nif(fr){fr.src=embed(start);}\nreturn pl;\n}\nvar f=document.createElement('iframe');\nf.src=embed(start);\nf.title='Infant hip ultrasound: the Graf method walkthrough';\nf.allow='accelerometer;autoplay;clipboard-write;encrypted-media;gyroscope;picture-in-picture';\nf.setAttribute('allowfullscreen','');\npl.innerHTML='';\npl.appendChild(f);\npl.classList.add('is-live');\nreturn pl;\n}\nvar p0=document.getElementById(\"sr-ih-player\");\nif(p0){p0.addEventListener('click',function(){mount(15);});}\nvar tx=document.getElementById('sr-ih-transcript');\nif(tx){\nif(window.matchMedia('(max-width:768px)').matches){tx.removeAttribute('open');}\n}\ndocument.addEventListener('click',function(e){\nvar t0=e.target;\nif(!t0){return;}\nif(!t0.closest){return;}\nvar a=t0.closest('[data-sr-seek]');\nif(!a){return;}\ne.preventDefault();\nvar pl=mount(a.getAttribute('data-sr-seek'));\nif(pl){pl.scrollIntoView({behavior:'smooth',block:'start'});}\n});\nvar toc=document.getElementById('sr-ih-toc');\nif(toc){\nvar links=[].slice.call(toc.querySelectorAll('a[href^=\"#\"]'));\nvar secs=[];\nvar map={};\nlinks.forEach(function(a){\nvar id=a.getAttribute('href').slice(1);\nvar el=document.getElementById(id);\nif(el){secs.push(el);map[id]=a;}\n});\nwindow.__srIhSpy=function(){\nif(!links.length){return;}\nvar line=window.innerHeight*0.28;\nvar idx=0;\nfor(var i=0;i<secs.length;i++){\nif(secs[i].getBoundingClientRect().top<=line){idx=i;}\n}\nlinks.forEach(function(l){l.classList.remove('sr-toc-active');});\nlinks[idx].classList.add('sr-toc-active');\n};\nif(window.IntersectionObserver){\nvar io=new IntersectionObserver(function(){window.__srIhSpy();},{rootMargin:'-12% 0px -72% 0px'});\nsecs.forEach(function(s){io.observe(s);});\n}\nwindow.__srIhSpy();\n}\nvar pr=document.getElementById('sr-ih-progress');\nvar tick=false;\nfunction upd(){\ntick=false;\nif(window.__srIhSpy){window.__srIhSpy();}\nvar h=document.documentElement;\nvar m=h.scrollHeight-h.clientHeight;\nvar v=m>0?Math.round(h.scrollTop\/m*100):0;\nif(pr){pr.textContent=v+'%';}\n}\nwindow.addEventListener('scroll',function(){\nif(tick){return;}\ntick=true;\nrequestAnimationFrame(upd);\n},{passive:true});\nupd();\n})();<\/script><br \/>\n<script type=\"application\/ld+json\">{\"@context\":\"https:\/\/schema.org\",\"@graph\":[{\"@type\":\"Article\",\"@id\":\"https:\/\/suresultmed.com\/infant-hip-ultrasound-graf-method\/#article\",\"headline\":\"Infant Hip Ultrasound: the 3-Minute D3Ultra Graf Method Walkthrough\",\"description\":\"An infant hip screened for developmental dysplasia on a handheld probe, run the way Graf specified it: one coronal image in the standard plane, three construction lines laid on the frozen frame, and two angles read against the published type table. Timestamped key moments, the settings read off the device screen, the alpha and beta bands drawn to scale, and the whole recording transcribed.\",\"datePublished\":\"2026-09-10\",\"dateModified\":\"2026-09-10\",\"inLanguage\":\"en-US\",\"mainEntityOfPage\":{\"@type\":\"WebPage\",\"@id\":\"https:\/\/suresultmed.com\/infant-hip-ultrasound-graf-method\/\"},\"image\":\"https:\/\/suresultmed.com\/wp-content\/uploads\/infant-hip-ultrasound-graf-method-cover.jpg\",\"author\":[{\"@type\":\"Person\",\"@id\":\"https:\/\/suresultmed.com\/#fernando-mariz-md\",\"name\":\"Fernando Mariz, MD\",\"jobTitle\":\"Gynecology and pelvic surgery physician\",\"url\":\"https:\/\/suresultmed.com\/author\/dr-fernando-mariz-md\/\",\"knowsAbout\":[\"Gynecology\",\"Pelvic surgery\",\"Sonography\",\"Point-of-care ultrasound\"]},{\"@type\":\"Person\",\"@id\":\"https:\/\/suresultmed.com\/#jailyn-avila-md\",\"name\":\"Jailyn Avila, MD\",\"jobTitle\":\"Emergency medicine physician and POCUS educator\",\"knowsAbout\":[\"Emergency medicine\",\"Point-of-care ultrasound\",\"Residency education\"]}],\"publisher\":{\"@type\":\"Organization\",\"@id\":\"https:\/\/suresultmed.com\/#organization\",\"name\":\"Suresult\",\"url\":\"https:\/\/suresultmed.com\/\"},\"video\":{\"@id\":\"https:\/\/suresultmed.com\/infant-hip-ultrasound-graf-method\/#video\"},\"about\":{\"@type\":\"MedicalTest\",\"name\":\"Infant hip ultrasound (Graf method) for developmental dysplasia of the hip\"},\"keywords\":\"infant hip ultrasound, graf method hip ultrasound, ddh ultrasound, hip dysplasia ultrasound, alpha angle hip ultrasound, beta angle, developmental dysplasia of the hip, pediatric POCUS\"},{\"@type\":\"Person\",\"@id\":\"https:\/\/suresultmed.com\/infant-hip-ultrasound-graf-method\/#presenter\",\"name\":\"Brandon Ramakko, DC\",\"jobTitle\":\"Neuromusculoskeletal medicine specialist and musculoskeletal ultrasound instructor\",\"url\":\"https:\/\/www.drramakko.com\/\",\"knowsAbout\":[\"Musculoskeletal ultrasound\",\"Point-of-care ultrasound\",\"Neuromusculoskeletal medicine\"]},{\"@type\":\"VideoObject\",\"@id\":\"https:\/\/suresultmed.com\/infant-hip-ultrasound-graf-method\/#video\",\"name\":\"Infant hip ultrasound by the Graf method \u2014 a full walkthrough with transcript\",\"description\":\"A three-minute developmental dysplasia of the hip screen on the linear array of a handheld probe at 10 MHz. Why the Ortolani and Barlow manoeuvres are specific but not sensitive, the coronal standard-plane image acquired with the leg at about 90 degrees, the four landmarks named on the frozen frame, and the Graf construction built on it \u2014 baseline along the ilium, bony roof line to alpha, cartilage roof line to beta \u2014 finishing at 71.6 and 48.6 degrees.\",\"thumbnailUrl\":[\"https:\/\/suresultmed.com\/wp-content\/uploads\/infant-hip-graf-coronal-landmarks-poster.jpg\"],\"uploadDate\":\"2025-10-06\",\"duration\":\"PT3M6S\",\"embedUrl\":\"https:\/\/www.youtube-nocookie.com\/embed\/NOCCenryxPg\",\"isFamilyFriendly\":true,\"inLanguage\":\"en\",\"publisher\":{\"@type\":\"Organization\",\"@id\":\"https:\/\/suresultmed.com\/#organization\",\"name\":\"Suresult\",\"url\":\"https:\/\/suresultmed.com\/\"},\"actor\":{\"@id\":\"https:\/\/suresultmed.com\/infant-hip-ultrasound-graf-method\/#presenter\"},\"mainEntityOfPage\":{\"@id\":\"https:\/\/suresultmed.com\/infant-hip-ultrasound-graf-method\/\"},\"transcript\":\"My name is Brandon Ramakko, and today we\u2019re going to be using a Suresult D3 handheld ultrasound unit to evaluate an infant\u2019s hip for hip dysplasia, or developmental dysplasia of the hip, DDH. Now, what this is: the hip joint could be sort of malformed; the joint can be a little too shallow, making it easy for the hip to dislocate. And the clinical test for this is called the Ortolani and Barlow test. There\u2019s two tests: basically you dislocate the hip and relocate the hip, and if you can do it just as easy as that, and you clunk and clunk, well then you know that you have hip dysplasia. So it\u2019s a very specific test, but those tests are not very sensitive \u2014 and in fact that combination of tests may miss two-thirds of hip dysplasia cases. So what\u2019s considered the best way of evaluating the hip for hip dysplasia is ultrasound. So wouldn\u2019t it be great if we could, you know, with a cheap ultrasound unit, evaluate the hip in less than a minute and have our answer? And that\u2019s what we can do. We\u2019ll be using this and something called the Graf method. We basically take one image in the coronal plane, we measure two angles, and we compare those angles to a chart, and then we have our answer. And it\u2019s as easy as that. I have a baby here, and we\u2019re going to take a coronal plane image with the leg at about 90 degrees. And here we go. And that\u2019s the image we want. We have the ilium here, we have the labrum here, we have the roof of the acetabulum here, we have our femoral head here. And I\u2019m actually going to start with putting down a line. I don\u2019t actually want to measure any lengths here, but this is basically the line we need to measure from for our angles. And now I have two angles I need to get: our alpha and our beta. So there\u2019s our alpha, and we need a second angle for our beta. Our alpha in this case is 71.6, and that needs to be larger than 60 \u2014 [larger than 60] is normal. If they\u2019re less than three months old, then it needs to be larger than 50. And for our beta angle, we want our beta angle to be less than 55. So for my baby: it\u2019s larger than 60, because it\u2019s 71.6, and it\u2019s less than 55, because it\u2019s 48.6. So my baby is fine, which is great. And that\u2019s it. It\u2019s as simple as that. [Sponsor segment omitted, 2:43\u20133:06.]\",\"hasPart\":[{\"@type\":\"Clip\",\"@id\":\"https:\/\/suresultmed.com\/infant-hip-ultrasound-graf-method\/#clip-15\",\"name\":\"What DDH is, and the two tests that look for it\",\"startOffset\":15,\"endOffset\":47,\"url\":\"https:\/\/suresultmed.com\/infant-hip-ultrasound-graf-method\/#t=15\"},{\"@type\":\"Clip\",\"@id\":\"https:\/\/suresultmed.com\/infant-hip-ultrasound-graf-method\/#clip-47\",\"name\":\"The number that justifies scanning at all\",\"startOffset\":47,\"endOffset\":60,\"url\":\"https:\/\/suresultmed.com\/infant-hip-ultrasound-graf-method\/#t=47\"},{\"@type\":\"Clip\",\"@id\":\"https:\/\/suresultmed.com\/infant-hip-ultrasound-graf-method\/#clip-60\",\"name\":\"What the Graf method actually asks of you\",\"startOffset\":60,\"endOffset\":79,\"url\":\"https:\/\/suresultmed.com\/infant-hip-ultrasound-graf-method\/#t=60\"},{\"@type\":\"Clip\",\"@id\":\"https:\/\/suresultmed.com\/infant-hip-ultrasound-graf-method\/#clip-79\",\"name\":\"Acquiring the coronal image\",\"startOffset\":79,\"endOffset\":91,\"url\":\"https:\/\/suresultmed.com\/infant-hip-ultrasound-graf-method\/#t=79\"},{\"@type\":\"Clip\",\"@id\":\"https:\/\/suresultmed.com\/infant-hip-ultrasound-graf-method\/#clip-91\",\"name\":\"The four landmarks, named on the frozen frame\",\"startOffset\":91,\"endOffset\":104,\"url\":\"https:\/\/suresultmed.com\/infant-hip-ultrasound-graf-method\/#t=91\"},{\"@type\":\"Clip\",\"@id\":\"https:\/\/suresultmed.com\/infant-hip-ultrasound-graf-method\/#clip-104\",\"name\":\"The baseline goes down first\",\"startOffset\":104,\"endOffset\":117,\"url\":\"https:\/\/suresultmed.com\/infant-hip-ultrasound-graf-method\/#t=104\"},{\"@type\":\"Clip\",\"@id\":\"https:\/\/suresultmed.com\/infant-hip-ultrasound-graf-method\/#clip-117\",\"name\":\"Alpha, then the start of beta\",\"startOffset\":117,\"endOffset\":127,\"url\":\"https:\/\/suresultmed.com\/infant-hip-ultrasound-graf-method\/#t=117\"},{\"@type\":\"Clip\",\"@id\":\"https:\/\/suresultmed.com\/infant-hip-ultrasound-graf-method\/#clip-127\",\"name\":\"The numbers, and the table they are read against\",\"startOffset\":127,\"endOffset\":163,\"url\":\"https:\/\/suresultmed.com\/infant-hip-ultrasound-graf-method\/#t=127\"}]},{\"@type\":\"FAQPage\",\"@id\":\"https:\/\/suresultmed.com\/infant-hip-ultrasound-graf-method\/#faq\",\"mainEntity\":[{\"@type\":\"Question\",\"name\":\"At what age is an infant hip ultrasound done?\",\"acceptedAnswer\":{\"@type\":\"Answer\",\"text\":\"From about six weeks of age. The ACR\u2013AIUM\u2013SPR\u2013SRU practice parameter states that because of physiologic laxity, hip sonography is usually not performed on patients younger than 6 weeks unless an abnormal physical finding calls for it, and that radiography is preferable from 6 months of age onward. The infant scanned in the recording above is five months old, inside that window at both ends. My own rule is to treat a very early scan as a question rather than an answer: laxity that would have resolved on its own reads as instability, and a separate 2022 review puts the false-positive risk specifically in the first four weeks.\"}},{\"@type\":\"Question\",\"name\":\"What is a normal alpha angle on an infant hip ultrasound?\",\"acceptedAnswer\":{\"@type\":\"Answer\",\"text\":\"Sixty degrees or more. In the Graf classification an alpha angle of 60\u00b0 or above is a Type I mature hip. Between 50\u00b0 and 59\u00b0 the reading depends entirely on age: at three months or younger it is Type IIa, physiological immaturity; the same 50\u201359\u00b0 after three months is Type IIb, a delay of ossification. Below that, 43\u201349\u00b0 is Type IIc and anything under 43\u00b0 is Type III or IV. The hip measured in the recording reads 71.6\u00b0, which sits well inside Type I.\"}},{\"@type\":\"Question\",\"name\":\"What does the beta angle add that alpha does not?\",\"acceptedAnswer\":{\"@type\":\"Answer\",\"text\":\"Alpha reads the bone; beta reads the cartilage the bone has not reached yet. Both are measured from the same baseline along the straight lateral wall of the ilium. Alpha is the angle out to the bony rim of the acetabulum, so it describes how deep the bony socket has become. Beta is the angle out through the centre of the cartilaginous labrum, so it describes how far the cartilage roof has been pushed up and outward by a head that is not seated deeply enough. Kang and Koo put the abnormal threshold at greater than 55\u00b0. The hip in the recording reads 48.6\u00b0.\"}},{\"@type\":\"Question\",\"name\":\"How much does the clinical examination miss on its own?\",\"acceptedAnswer\":{\"@type\":\"Answer\",\"text\":\"Enough that a normal Barlow and Ortolani is not an all-clear. Barlow dislocates the hip, Ortolani relocates it, and a felt clunk on either is the positive finding \u2014 a click is not. In a series of 5,701 newborns screened both ways, with Graf-method ultrasound as the reference standard, clinical examination came out 28.1% sensitive and 94.5% specific: 240 of the 334 hips that ultrasound graded Graf IIb or worse were read as normal on examination. A separate review puts the physical exam at 37% sensitive for frank dislocation. Different studies and different denominators, and they point the same way \u2014 the examination is good at confirming and poor at excluding.\"}},{\"@type\":\"Question\",\"name\":\"Can this scan be done on a general-purpose handheld probe?\",\"acceptedAnswer\":{\"@type\":\"Answer\",\"text\":\"It is, in the recording above, on the linear array of a D3Ultra at 10 MHz, and all three standard-plane landmarks stay legible. Two things I would set differently. The depth is left at 60 mm when the acetabulum sits inside the top 30, so half the field is spent on tissue nobody is reading and the anatomy is drawn smaller than it needs to be. And 10 MHz is the ceiling on that array: a dedicated 12 to 18 MHz linear head resolves the tip of the labrum more crisply, and the labral tip is the structure the beta angle hangs on. Neither point stops you taking the angles. Both make them easier to defend.\"}}]},{\"@type\":\"BreadcrumbList\",\"@id\":\"https:\/\/suresultmed.com\/infant-hip-ultrasound-graf-method\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"https:\/\/suresultmed.com\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"Scan Library\",\"item\":\"https:\/\/suresultmed.com\/suresult-video-library\/\"},{\"@type\":\"ListItem\",\"position\":3,\"name\":\"Infant hip ultrasound: the Graf method walkthrough\",\"item\":\"https:\/\/suresultmed.com\/infant-hip-ultrasound-graf-method\/\"}]}]}<\/script><\/p>\n","protected":false},"excerpt":{"rendered":"<p>A developmental hip screen run end to end on the linear array of a handheld probe &mdash; one coronal image,<\/p>","protected":false},"author":1,"featured_media":35945,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"_seopress_titles_title":"Infant Hip Ultrasound: the Graf Method, Step by Step","_seopress_titles_desc":"One coronal image, three lines, two angles read against Graf\u2019s table \u2014 timestamped, with the on-screen settings and the full transcript.","_seopress_robots_index":"","_seopress_robots_follow":"","_seopress_robots_imageindex":"","_seopress_robots_snippet":"","_seopress_robots_primary_cat":"","_seopress_robots_breadcrumbs":"","_seopress_robots_freeze_modified_date":"","_seopress_robots_custom_modified_date":"","_seopress_robots_canonical":"","_seopress_social_fb_title":"","_seopress_social_fb_desc":"","_seopress_social_fb_img":"https:\/\/suresultmed.com\/wp-content\/uploads\/infant-hip-ultrasound-graf-method-cover.jpg","_seopress_social_fb_img_attachment_id":35945,"_seopress_social_fb_img_width":1600,"_seopress_social_fb_img_height":900,"_seopress_social_twitter_title":"","_seopress_social_twitter_desc":"","_seopress_social_twitter_img":"https:\/\/suresultmed.com\/wp-content\/uploads\/infant-hip-ultrasound-graf-method-cover.jpg","_seopress_social_twitter_img_attachment_id":35945,"_seopress_social_twitter_img_width":1600,"_seopress_social_twitter_img_height":900,"_seopress_redirections_value":"","_seopress_redirections_enabled":"","_seopress_redirections_enabled_regex":"","_seopress_redirections_logged_status":"","_seopress_redirections_param":"","_seopress_redirections_type":0,"_seopress_analysis_target_kw":"","_seopress_news_disabled":"","_seopress_video_disabled":"","_seopress_video":[],"_seopress_pro_schemas_manual":[],"_seopress_pro_rich_snippets_disable_all":"","_seopress_pro_rich_snippets_disable":[],"_seopress_pro_schemas":[],"footnotes":""},"categories":[457],"tags":[],"class_list":["post-35935","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-scan-library"],"acf":[],"_links":{"self":[{"href":"https:\/\/suresultmed.com\/ja\/wp-json\/wp\/v2\/posts\/35935","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/suresultmed.com\/ja\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/suresultmed.com\/ja\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/suresultmed.com\/ja\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/suresultmed.com\/ja\/wp-json\/wp\/v2\/comments?post=35935"}],"version-history":[{"count":7,"href":"https:\/\/suresultmed.com\/ja\/wp-json\/wp\/v2\/posts\/35935\/revisions"}],"predecessor-version":[{"id":35996,"href":"https:\/\/suresultmed.com\/ja\/wp-json\/wp\/v2\/posts\/35935\/revisions\/35996"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/suresultmed.com\/ja\/wp-json\/wp\/v2\/media\/35945"}],"wp:attachment":[{"href":"https:\/\/suresultmed.com\/ja\/wp-json\/wp\/v2\/media?parent=35935"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/suresultmed.com\/ja\/wp-json\/wp\/v2\/categories?post=35935"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/suresultmed.com\/ja\/wp-json\/wp\/v2\/tags?post=35935"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}