A Deep Learning–Based Framework for Automatic Determination of Developmental Dysplasia of the Hip from Graf Angles

Developmental dysplasia of the hip (DDH) is a common neonatal condition that necessitates early diagnosis to ensure effective treatment. The traditional Graf method, while widely used for evaluating infant hips via ultrasound, is limited by operator dependency and measurement variability. This research has proposed a framework using deep learning network, morphological operation and local maxima method to diagnose DDH in newborns using ultrasound images. The method utilizes DeepLabv3 + for image segmentation, evaluating multiple backbone architectures (ResNet50, InceptionResNetV2, MobilenetV2, and Xception) to identify the region of interest accurately. Local maxima method was used to determine the extremum points of the line defining the Graf angles. Denoising filters, including mean, median, and Wiener, are applied to determine local maxima points accurately. The evaluation comprises two stages: first, assessing the performance of DeepLabv3 + backbones in producing masks for Graf angles determination, and second, comparing the angles obtained through proposed framework with those determined by expert radiologists. Comparative analysis demonstrates that MobileNetV2 (94.64 accuracy, 86.99 Cohen’s kappa, 94.31 F-score) surpasses other models in segmentation accuracy and measurement reliability. This conclusion is backed by key performance metrics such as accuracy, IoU, PSNR, F-score, SSIM, Cohen’s kappa, as well as by the intraclass correlation coefficient and Bland–Altman analyses. The proposed framework shows considerable promise in automating hip ultrasound analysis for DDH diagnosis, minimizing operator dependency while enhancing measurement consistency.