Using artificial intelligence and 3-D ultrasound to help babies

Edmonton project screens for infant hip dysplasia to prevent painful problems in adults

If Jacob Jaremko has his way, every Alberta newborn will soon be screened for hip dysplasia, a common hip joint problem that is easily fixed if detected in the first three months of life.

In Alberta, four babies are born with hip dysplasia every day, so it’s surprising that widespread screening isn’t already done. Of those born with hip dysplasia, 80 per cent are girls.

“On the face of it, it seems crazy that there was no regular screening before,” says Jaremko, an Edmonton radiologist. But previous technology was not cost-effective or reliable, he says. With the arrival of 3-D ultrasound and artificial intelligence, “the future is now for this to finally happen.”

Jaremko calls hip dysplasia a “silent condition,” where the baby’s hip joint is poorly formed.
Some doctors check babies for the problem but unless it’s a severe case, there are no symptoms until the patient is a teenager or a young adult, when she starts developing early arthritis. In adults, it not only causes pain and instability, but adds huge costs to the healthcare system for arthritis treatments and joint-replacement surgeries.

All that could be prevented with early treatment. In the first three months of life, the cartilage in a baby’s hips is soft and the problem can usually be reversed with a simple soft harness worn for six to 12 weeks. A few babies need to wear a spica (body) cast and occasionally, surgery is needed.

Jaremko is investigating using 3-D ultrasound to screen for infant hip dysplasia because 2-D pictures of the hip do not tell the whole story. Key to the project has been his team’s development of an artificial intelligence system that can read and analyse the ultrasound findings, quickly and accurately.

An Innovation grant from WCHRI is allowing Jaremko and an orthopedic surgeon at the Stollery Children’s Hospital’s pediatric orthopedic clinic to test the accuracy of the automated analysis. He hopes to involve 200 babies in the pilot project, which began last fall.

The next stage will be even more exciting. Jaremko and his team are applying for an Alberta Innovates grant to allow them to screen infants visiting well-baby clinics in Edmonton for their regular vaccinations and weight checks. The screening would be done with a portable 2-D ultrasound unit, which saves a video and simulates a 3-D model.

The advantage is that the scan would be done by a nurse, who can be easily trained on the unit, and the analysis would be done quickly through artificial intelligence. If the simplified screening shows a problem, the baby would be referred to the hospital for a high-quality 3-D ultrasound, to be read by a radiologist.

Screening across Alberta could be in place within five years, he believes, but it will depend on his research showing the cost benefits. “It’s going to cost more in year one, but there will be substantial cost savings for the province later.”

Jaremko believes parents will welcome the screening. “It’s a simple, harmless, painless procedure and it gives them confidence that their baby’s hips are normal. That’s a pretty nice bit of news that you get when you leave your well-baby visit.”

Jaremko was supported by the Stollery Children’s Hospital Foundation through WCHRI.

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