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Ultrasound screening for developmental dysplasia of the hip

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Abstract

Background

Clinical examination of newborns has been shown to be inadequate for the early detection of developmental dysplasia of the hip (DDH). It is debatable whether US examination is a valid alternative.

Objective

To contribute further knowledge to the natural history of DDH; to examine the distribution of hip morphology as classified by Graf according to sex and risk factors in an unselected Italian population; to propose a temporal pattern of US screening of all newborns to detect DDH.

Materials and methods

All newborns (n=8,896) sequentially delivered in the Maternal and Child Health Hospital of Milan underwent US examination in the first week of life and, when findings were within normal limits, in the third month of life. Subjects categorised at birth as Graf type 2a with α angle between 50° and 52°, underwent a further US examination at the end of the first month of life. Subjects with ambiguous findings at the 3-month examination were re-examined at the end of the fourth month of life. All infants with abnormal hips abandoned the screening process and underwent treatment.

Results

Overall, 56 cases of DDH were identified: 34 in the first week of life examination, 10 at 1 month; 10 at 3 months and 2 at 4 months.

Conclusions

A two-step US screening of newborns is recommended: at the end of the first month and within the fourth month of life.

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References

  1. Berman L, Kleneman L (1986) Ultrasound screening for hip abnormalities: preliminary findings in 1001 neonates. BMJ 293:719–722

    CAS  PubMed  Google Scholar 

  2. Castelein RM, Sauter AJ (1988) Ultrasound screening for congenital dysplasia of the hip in newborns: its value. J Pediatr Orthop 8:666–670

    CAS  PubMed  Google Scholar 

  3. De Pellegrin M, Tessari L (1966) Early ultrasound diagnosis of developmental dysplasia of the hip. Bull Hosp Jt Dis Orthop Inst 54:222–225

    Google Scholar 

  4. Harcke HT, Kumar SJ (1991) The role of ultrasound in the diagnosis and management of congenital dislocation and dysplasia of the hip. J Bone Joint Surg Am 73:622–628

    CAS  PubMed  Google Scholar 

  5. Psenner K, Ortore P, Fodor G, et al (1990) Echography of the hip of the newborn infant (in Italian). Radiol Med (Torino) 79:575–581

    Google Scholar 

  6. Riboni G, Serantoni S, De Simoni M, et al (1991) Echography of the hip in the newborn. 1507 cases (in Italian). Radiol Med (Torino) 81:53–57

    Google Scholar 

  7. Schuler P, Feltes E, Kienapfel H, et al (1990) Ultrasound examination for the early determination of dysplasia and congenital dislocation of neonatal hips. Clin Orthop 258:18–26

    PubMed  Google Scholar 

  8. Tonnis D, Storch K, Ulbrich H (1990) Results of newborn screening for CDH with and without sonography and correlation of risk factors. J Pediatr Orthop 10:145–152

    CAS  PubMed  Google Scholar 

  9. Tschauner C, Klapsch W, Graf R (1990) Sonographic neonatal screening of the hip joint--luxury or necessity? (in German) Monatsschr Kinderheilkd 138:429–433

    Google Scholar 

  10. Graf R, Schuler P (1986) Echographie de la hanche du nouveau-né et du nourisson. Sauramps Medical, Montpellier

  11. Graf R (1987) Sonographic diagnosis of hip dysplasia. Principles, sources of error and consequences (in German). Ultraschall Med 8:2–8

    CAS  PubMed  Google Scholar 

  12. Graf R (1980) The diagnosis of congenital hip-joint dislocation by the ultrasonic compound treatment. Arch Orthop Trauma Surg 97:117–133

    CAS  PubMed  Google Scholar 

  13. Graf R (1983) New possibilities for the diagnosis of congenital hip joint dislocation by ultrasonography. J Pediatr Orthop 3:354–359

    CAS  PubMed  Google Scholar 

  14. Graf R (1984) Classification of hip joint dysplasia by means of sonography. Arch Orthop Trauma Surg 102:248–255

    Google Scholar 

  15. Graf R, Schuler P (1986) Sonography of the infant hip: an atlas. VCH Verlagsgesellschaft, Weinheim

    Google Scholar 

  16. Graf R, Tschauner C, Steindl M (1987) Does the IIa hip need treatment? Results of a longitudinal study of sonographically controlled hips of infants less than 3 months of age (in German). Monatsschr Kinderheilkd 135:832–837

    CAS  PubMed  Google Scholar 

  17. Graf R (1990) Sonography of the hip in infants (in German). Z Orthop Ihre Grenzgeb 128:355–356

    CAS  PubMed  Google Scholar 

  18. Graf R (1983) The sonographic evaluation of hip dysplasia using convexity diagnosis (in German). Z Orthop 121:693–702

    CAS  PubMed  Google Scholar 

  19. Couture A, Baud C, Ferran J-L, et al (1988) L'échographie de la hanche chez l'efant. Editions Axone, Montpellier

  20. Canepa G, Pelizza A, Pietrogrande V (1987) Le malattie dello scheletro in età evolutiva. Piccin, Padova

  21. Niethard FU (1990) Radiographic study of the hip in infancy and early childhood (in German). Z Orthop Ihre Grenzgeb 128:357–360

    CAS  PubMed  Google Scholar 

  22. Ortore P, Fodor G, Silverio R, et al (1996) Ultrasonography of the neonatal hip: state of the art and perspectives (in Italian). Radiol Med (Torino) 92:10–15

    Google Scholar 

  23. Schuler P (1990) The hip joint of children. Clinical diagnosis in the infant (in German). Z Orthop Ihre Grenzgeb 128:351–354

    CAS  PubMed  Google Scholar 

  24. Tomà P, Valle M, Rossi U, et al (2001) Paediatric hip-ultrasound for developmental dysplasia of the hip: a review. Eur J Ultrasound 14:45–55

    Article  PubMed  Google Scholar 

  25. Ganger R, Grill F, Leodolter S, et al (1991) Ultrasound screening of the neonatal hip: results and experiences (in German). Ultraschall Med 12: 25–30

    CAS  PubMed  Google Scholar 

  26. Schuler P (1987) Principles of sonographic examination of the hip (in German). Ultraschall Med 8: 9–13

    CAS  PubMed  Google Scholar 

  27. Sósnierz A, Karel M, Maj S, et al (1991) Ultrasound appearance of the hip joint in newborns during the first week of life. J Clin Ultrasound 19:271–274

    PubMed  Google Scholar 

  28. Szoke N, Kuhl L, Heinrichs J (1988) Ultrasound examination in the diagnosis of congenital hip dysplasia of newborns. J Pediatr Orthop 8: 12–16

    CAS  PubMed  Google Scholar 

  29. Teot L, Deschamps F (1988) Echographie de la hanche de l'enfant. Sauramps Medical, Montpellier

  30. Donaldson JS (1994) The use of sonography in screening for developmental dysplasia of the hip. AJR 163:399–400

    Google Scholar 

  31. Geitung JT, Rosendahl K, Sudmann E (1996) Cost-effectiveness of ultrasonographic screening for congenital hip dysplasia in new-borns. Skeletal Radiol 25:251–254

    Article  CAS  PubMed  Google Scholar 

  32. Kernohan G, Trainor B, Mollan R, et al (1991) Cost of treatment of congenital dislocation of the hip. Int J Health Plann Manage 6:229–233

    CAS  PubMed  Google Scholar 

  33. Suzuki S, Yamamuro T (1990) Avascular necrosis in patients treated with the Pavlik harness for congenital dislocation of the hip. J Bone Joint Surg Am 72:1048–1055

    CAS  PubMed  Google Scholar 

  34. Terjesen T, Holen KJ, Tegnander A (1996) Hip abnormalities detected by ultrasound in clinically normal newborn infants. J Bone Joint Surg Br 78:636–640

    CAS  PubMed  Google Scholar 

  35. Tschauner C, Klapsch W, Graf R (1993) The effect of ultrasonography screening of hips in newborn infants on femur head necrosis and the rate of surgical interventions (in German). Orthopäde 22:268–276

    Google Scholar 

  36. Carter CO, Wilkinson JA (1964) Genetic and environmental factors in the etiology of congenital dislocation of the hip. Clin Orthop 33: 119–128

    CAS  PubMed  Google Scholar 

  37. Rosendahl K, Markestad T, Lie RT (1994) Ultrasound screening for developmental dysplasia of the hip in the neonate: the effect on treatment rate and prevalence of late cases. Pediatrics 94:47–52

    CAS  PubMed  Google Scholar 

  38. Harcke HT (1995) The role of ultrasound in diagnosis and management of developmental dysplasia of the hip. Pediatr Radiol 25:225–227

    CAS  PubMed  Google Scholar 

  39. Burger BJ, Burger JD, Bos CF, et al (1990) Neonatal screening and staggered early treatment for congenital dislocation of dysplasia of the hip. Lancet 336:1549–1553

    CAS  PubMed  Google Scholar 

  40. Castelein RM, Sauter AJ, De Vlieger M, et al (1992) Natural history of ultrasound hip abnormalities in clinically normal newborns. J Pediatr Orthop 12:423–427

    CAS  PubMed  Google Scholar 

  41. Clarke NM, Clegg J, Al-Chalabi AN (1989) Ultrasound screening of hips at risk for CDH. Failure to reduce the incidence of late cases. J Bone Joint Surg Br 71:9–12

    CAS  PubMed  Google Scholar 

  42. Teanby DN, Paton RW (1997) Ultrasound screening for congenital dislocation of the hip: a limited targeted programme. J Pediatr Orthop 17:202–204

    Article  CAS  PubMed  Google Scholar 

  43. Larchet M, Schiller P, Amram D, et al (1989) Role of echography in the screening of congenital hip luxation at a maternity department (in French). J Gynecol Obstet Biol Reprod (Paris) 18:735–739

    Google Scholar 

  44. Pauer M, Rossak K, Meilchen J (1988) Hip screening of newborn infants. Type classification, therapy and follow-up (in German). Z Orthop Ihre Grenzgeb 126:260–265

    CAS  PubMed  Google Scholar 

  45. Rosendahl K, Markestad T, Lie RT (1996) Developmental dysplasia of the hip. A population-based comparison of ultrasound and clinical findings. Acta Paediatr 85:64–69

    CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Radiology, Macedonio Melloni Hospital, Milan, Italy

    Giuseppe Riboni, Sergio Serantoni & Elena Rognoni

  2. Department of Epidemiology, Local Health Authority, Corso Italia 19, 20122 Milan, Italy

    Aldo Bellini & Luigi Bisanti

Authors
  1. Giuseppe Riboni
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  2. Aldo Bellini
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  3. Sergio Serantoni
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  4. Elena Rognoni
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  5. Luigi Bisanti
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Corresponding author

Correspondence to Luigi Bisanti.

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Riboni, G., Bellini, A., Serantoni, S. et al. Ultrasound screening for developmental dysplasia of the hip. Pediatr Radiol 33, 475–481 (2003). https://doi.org/10.1007/s00247-003-0940-7

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  • DOI: https://doi.org/10.1007/s00247-003-0940-7

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