Skip to main content
SpringerLink
Log in

Developmental Dysplasia of the Hip

  • Chapter
  • First Online:
Evidence-Based Imaging in Pediatrics

  • 1678 Accesses

Key Points

■ Skilled clinical examiners are capable of detecting the vast majority of developmental dysplasia of the hip (DDH) in neonates, and this remains the primary screening method in the United States. Ultrasound (US) is no better than these examiners but may improve DDH diagnosis or exclusion for less-experienced clinical examiners (strong evidence).

■ The great majority of hips with neonatal laxity will spontaneously become normal (strong evidence). Of the newborns labeled as DDH by either clinical or US screening, about 90% will spontaneously become normal without treatment (strong evidence). When there is a displaced femoral head and acetabular dysplasia found from late-appearing DDH in a toddler or a preschooler, this usually will lead to an unfavorable long-term result and the need for corrective orthopedic procedures (strong evidence).

■ The main aim of health care in DDH is to detect and treat DDH early and in doing so avoid multiple corrective procedures and prevent lifelong hip disease with significant costs (strong evidence).

■ US hip imaging in neonates and infants, whether the static or the dynamic method, is highly sensitive to DDH when done by experienced operators but is not specific (false positives). The low specificity leads to overtreatment, excessive imaging, and higher costs. Like the clinical exam, the use of hip US may not prevent late DDH (moderate evidence).

■ Hip US for DDH evaluation should not be performed prior to age 3 weeks due to normal neonatal hip laxity that produces high false-positive rates (moderate evidence).

■ Conflicting data remain concerning the role of general neonatal or infant population US hip screening with regard to late emergence of DDH and its cost-effectiveness (moderate evidence).

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 84.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 109.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Eastwood D M. Lancet 2003;361(9357): 595–597.

    Article  PubMed  Google Scholar 

  2. Kocher MS. Am J Orthop 2000;29(12): 929–933.

    CAS  PubMed  Google Scholar 

  3. Kocher MS. Am J Orthop 2001; 30(1): 19–24

    CAS  PubMed  Google Scholar 

  4. Dezateux C, Rosendahl K. Lancet 2007;369(9572): 1541–1552.

    Article  PubMed  Google Scholar 

  5. Holen K, Tegnander A et al. J Bone Joint Surg Br 2002;84-B(6): 886–890.

    Article  Google Scholar 

  6. Hennrikus WL. Pediatr Ann 1999;28(12): 740–746.

    CAS  PubMed  Google Scholar 

  7. Patel H, Care CPFOPH. CMAJ 2001;164(12): 1669–1677.

    CAS  PubMed  Google Scholar 

  8. Storer SK, Skaggs DL. Am Fam Physician 2006;74(8): 1310–1316.

    PubMed  Google Scholar 

  9. Witt C. Adv Neonatal Care 2003; 3(2): 65–75.

    Article  PubMed  Google Scholar 

  10. Lehmann HP, Hinton R, Morello P et al. Pediatrics 2003;105 (4): e57.

    Article  Google Scholar 

  11. Guille JT, Pizzutillo PD et al. J Am Acad Orthop Surg 2000;8(4): 232–242.

    CAS  PubMed  Google Scholar 

  12. Hobbs DL, Mickelsen W et al. Radiol Technol 2007;78(5): 423–428.

    PubMed  Google Scholar 

  13. Lee MC, Eberson CP. Orthop Clin N Am 2006;37(2): 119–132.

    Article  Google Scholar 

  14. Scherl SA. Pediatrics in Review 2004;25(2): 52–62.

    PubMed  Google Scholar 

  15. Soo B, Howard J, Boyd RN et al. J Bone Joint Surg Am 2006; 88(1): 121–129

    Article  PubMed  Google Scholar 

  16. Taybi H, Lachman RS. Radiology of Syndromes, Metabolic Disorders, and Skeletal Dysplasias, 4th edn. St. Louis: Mosby-Year Book, 1996.

    Google Scholar 

  17. Woolacott, NF, Puhan MA et al. BMJ 2005;330(7505): 1413–1418.

    Article  PubMed  Google Scholar 

  18. French L, Dietz F. Am Fam Physician 1999;60(1): 177–184.

    CAS  PubMed  Google Scholar 

  19. Goldberg MJ. Pediatrics in Review 2002;22(4): 131–134.

    Google Scholar 

  20. Kohler G, Hell A. Swiss Med Wkly 2003;133(35–36): 484–487.

    CAS  PubMed  Google Scholar 

  21. Puhan MA, Woolacott N et al. Ultraschall Med (Stuttgart, Germany: 1980) 2003;24(6): 377–382.

    Article  CAS  PubMed  Google Scholar 

  22. Roovers EA.M, Boere-Boonekamp M et al. Arch Dis Child Fetal Neonatal Ed 2005;90(1): F25–F30.

    Article  CAS  PubMed  Google Scholar 

  23. Rosendahl K, Toma P. Euro Radiol 2007;17(8): 1960–1967.

    Article  Google Scholar 

  24. Shipman SA, Helfand M et al. Pediatrics 2006;117(3): e557–e576.

    Article  PubMed  Google Scholar 

  25. Toma P, Valle M et al. Euro J Ultrasound 2001;14(1): 45–55.

    Article  CAS  Google Scholar 

  26. Gray A, Elbourne D et al. J Bone Joint Surg Am 2005;87(11): 2472–2479.

    Article  PubMed  Google Scholar 

  27. Bellah R. Radiol Clin N Am 2001;39(4): 597–618.

    Article  CAS  PubMed  Google Scholar 

  28. Grissom LE, Harcke HT. Curr Opin Pediatr 1999;11(1): 66–69.

    Article  CAS  PubMed  Google Scholar 

  29. Harcke H. Clin Orthop Relat Res 2005;434: 71–77.

    Article  PubMed  Google Scholar 

  30. Harcke HT, Grissom LE. Radiol Clin N Am 1999;37(4): 787–796.

    Article  CAS  PubMed  Google Scholar 

  31. Hosny G, Koizumi W et al. J Pediatr Orthop B 2002;11(3): 204–211.

    Article  PubMed  Google Scholar 

  32. Hubbard AM. Radiol Clin N Am 2001;39(4): 721–732.

    Article  CAS  PubMed  Google Scholar 

  33. Portinaro N, Pelillo F et al. J Pediatr Orthop 2007;27(2): 247–250.

    PubMed  Google Scholar 

  34. Smergel E, Losik SB et al. Ultrasound Q 2004;20(4): 201–216.

    Article  PubMed  Google Scholar 

  35. Synder M, Harcke HT et al. Orthop Clin N Am 2006;37(2): 141–147.

    Article  Google Scholar 

  36. Wedge JH. J Bone Joint Surg 2003; American Volume 85-A(8): 1623–1623.

    PubMed  Google Scholar 

  37. Wientroub S, Grill F. J Bone Joint Surg Am 2000;82(7): 1004.

    PubMed  Google Scholar 

  38. Abril J, Berjano P et al. J Pediatr Orthop B 1999;8(4): 264–267.

    Article  CAS  PubMed  Google Scholar 

  39. Aoki K, Mitani S et al. J Orthop Sci 1999;4(4): 255–263.

    Article  CAS  PubMed  Google Scholar 

  40. Dillon JE, Connolly SA et al. Magn Reson Imaging Clin N Am 2005;13(4): 783–797.

    Article  PubMed  Google Scholar 

  41. Clegg J, Bache CE et al. J Bone Joint Surg Br 1999;81-B(5):852–857.

    Article  Google Scholar 

  42. Murray KA, Crim JR. Semin Ultrasound CT MR 2001;22(4): 306–340.

    Article  CAS  PubMed  Google Scholar 

  43. Ortolani M. La Pediatr 1937;45;129–131.

    Google Scholar 

  44. Barlow TG. J Bone Joint Surg Br 1962;44;292–294.

    Google Scholar 

  45. Bloomfield L, Rogers C et al. J Med Screen 2003;10: 4.

    Article  Google Scholar 

  46. Gardiner HM, Clarke NM, Dunn PM. J Pediatr Orthop 1990; 10(5):633–637.

    CAS  PubMed  Google Scholar 

  47. Wood M, ConboyV et al. J Pediatr Orthop 2000;20(3): 302–305.

    Article  CAS  PubMed  Google Scholar 

  48. Force, USPST. Am Fam Physician 2003;73(11): 1992–1996.

    Google Scholar 

  49. Elbourne D, Dezateux C et al. Lancet 2002;360(9350): 2009–2017.

    Article  PubMed  Google Scholar 

  50. Forlin E, Munhoz da Cunha LA et al. Orthop Clin N Am 2006;37(2): 149–160.

    Article  Google Scholar 

  51. Ganger R, Radler C et al. J Pediatr Orthop B 2005;14(3): 139–150.

    PubMed  Google Scholar 

  52. Gillett CA. AORN J 2002;75(4): 737.

    Article  PubMed  Google Scholar 

  53. Gillingham BL, Sanchez AA et al. J Am Acad Orthop Surg 1999;7(5): 325–337.

    CAS  PubMed  Google Scholar 

  54. Kim S, Frick S et al. J Pediatr Orthop 1999;19(4): 438–442.

    Article  CAS  PubMed  Google Scholar 

  55. Macnicol M, Bertol P. J Pediatr Orthop B 2005;14(6): 415–421.

    PubMed  Google Scholar 

  56. Trousdale R. Clin Orthop Relat Res 2004; 429: 182–187.

    Article  PubMed  Google Scholar 

  57. Rosendahl K, Markestad T, Lie RT. Pediatrics 1994; 94: 47–52.

    CAS  PubMed  Google Scholar 

  58. Morin C, Harcke HT, MacEwen GD. Radiology 1985; 157: 673–677.

    CAS  PubMed  Google Scholar 

  59. American College of Radiology Appropriateness Criteria. Developmental Dysplasia of the Hip- Child.http://www.acr.org/SecondaryMainMenuCategories/quality_safety/app_criteria/pdf/ExpertPanelonPediatricImaging/DevelopmentalDysplasiaoftheHipChildDoc1.aspx

  60. Garn SM, Rohmann CG, Silverman FN. Med Radiogr Photogr 1967; 43(2):45–66.

    CAS  PubMed  Google Scholar 

  61. Kay RM, Watts HG, Dorey FJ. J Pediatr Orthop 1997;17(2):170–173.

    Article  CAS  PubMed  Google Scholar 

  62. Spatz DK, Reiger M, Klaumann M et al. J Pediatr Orthop 1997;17(2):174–175.

    CAS  PubMed  Google Scholar 

  63. Pirpiris M, Payman KR, Otsuka NY. J Pediatr Orthop 2006; 26(3):310–315.

    PubMed  Google Scholar 

  64. Hernandez RJ. Radiology 1984;150: 266–268.

    CAS  PubMed  Google Scholar 

  65. Laor T, Roy DR, Mehlman CT. J Pediatr Orthop 2000;20:572–574.

    CAS  PubMed  Google Scholar 

  66. Grissom L, Harcke HT, Thacker M. Clin Orthop Relat Res 2008;466:791–801.

    Article  PubMed  Google Scholar 

  67. Jari S, Paton RW, Srinivasan MS. JBJS 2002; 84-B: 104–107.

    Google Scholar 

  68. Dogruel H, Atalar H, Yavuz O, Sayli U. Int Orthop 2008;32(3);415–419.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Radiology, Children’s Hospital of Philadelphia, 19104, Philadelphia, PA, USA

    Marc S. Keller & Els L.F. Nijs MD (Assistant Professor of Radiology)

  2. Department of Radiology, Emory University School of Medicine, 30322, Atlanta, Georgia, USA

    Kimberly E. Applegate MD, MS, FACR (Vice Chair of Quality and Safety)

Authors
  1. Marc S. Keller
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Els L.F. Nijs MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Kimberly E. Applegate MD, MS, FACR
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Marc S. Keller .

Editor information

Editors and Affiliations

  1. Dept. Radiology, Miami Children's Hospital, SW 114 Street 7420, Miami , 33156, U.S.A.

    L. Santiago Medina

  2. Dept. Radiology, Riley Children's Hospital, Barnhill Drive 702 , Indianapolis, 46202-5200, U.S.A.

    Kimberly E. Applegate

  3. Harborview Medical Center, University of Washington, Ninth Avenue 325, Seattle, 98104-2499, U.S.A.

    C. Craig Blackmore

Rights and permissions

Reprints and permissions

Copyright information

© 2010 Springer Science+Business Media, LLC

About this chapter

Cite this chapter

Keller, M.S., Nijs, E.L., Applegate, K.E. (2010). Developmental Dysplasia of the Hip. In: Medina, L., Applegate, K., Blackmore, C. (eds) Evidence-Based Imaging in Pediatrics. Springer, New York, NY. https://doi.org/10.1007/978-1-4419-0922-0_20

Download citation

  • DOI: https://doi.org/10.1007/978-1-4419-0922-0_20

  • Published:

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4419-0921-3

  • Online ISBN: 978-1-4419-0922-0

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation