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Auditing hip ultrasound screening of infants at increased risk of developmental dysplasia of the hip
  1. C A Lowry1,
  2. V B Donoghue2,
  3. J F Murphy1
  1. 1Department of Neonatology, The National Maternity Hospital, Holles Street, Dublin 2, Eire
  2. 2Department of Radiology, The National Maternity Hospital, Holles Street, Dublin 2, Eire
  1. Correspondence to:
    Dr C A Lowry
    Department of Neonatology, The National Maternity Hospital, Holles Street, Dublin 2, Eire; lowryclodaghhotmail.com

Abstract

Background: Clinical examination, while useful, has been shown to be insufficient as the sole screening method in infants. Ultrasound examination at 8 weeks in high risk infants is an integral part of the screening process in some units.

Aims: To show the efficiency of hip sonography in detection of developmental dysplasia of the hips in those without clinically dislocated hips.

Methods: All infants born at the National Maternity Hospital between January 1994 and December 2001 were included. All those with clinically dislocated hips were treated by a Pavlik harness and referred for follow up to a paediatric orthopaedic surgeon. An 8 week hip ultrasound scan was performed for those infants with stable hips on examination but who met the following criteria: (1) a first degree relative with congenital dislocation of hips; (2) breech presentation at birth; and (3) a persistent “click” at birth in an otherwise stable hip.

Results: During the period of study a total of 52 893 infants were born in the National Maternity Hospital. Based on the criteria above, 5485 hip ultrasound scans were performed. Of those scanned, 18 (0.33%) were found to have dislocated hips and 153 (2.78%) to have dysplasic hips. The 18 infants with dislocation were treated with Pavlik harness; the remaining 153 were followed up by serial ultrasound examinations but did not require active intervention.

Conclusions: Among the population of infants at increased risk of developmental dysplasia of the hip, the hip screening programme identified 18 cases among 5485 infants; a rate of 3.2 per 1000. Hip sonography is therefore worthwhile.

  • ultrasound
  • screening
  • developmental dysplasia of the hip
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Footnotes

  • Competing interests: none declared

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