Ultrasound screening for developmental dysplasia of the hip and its socioeconomic impact: Experience of tertiary care health level

Abstract

Objective: The purpose of this study was to investigate the usefulness of screening ultrasound to detect developmental dysplasia of the hip in infants with risk factors and to assess its socioeconomic impact. Patients and methods: This is a retrospective study. In the duration of 30 months, all infants born at Hospitals in our region were examined clinically for hip dislocation. All those with clinically dislocated hips were excluded and referred for follow up to a pediatric orthopedic surgeon. After referral to our tertiary care center, a 6 week hip ultrasound scan was performed for those infants with stable hips on examination, having risk factors for dysplastic hips including positive family history, breech presentation and inconclusive clinical findings. We used an ultrasound technique that combines the two known methods (Graf’s technique and Harcke’s method). Results: 3540 Hip ultrasound scans were performed, of those scanned 12 (0.33%) were found to have dislocated hips and 98 (2.8%) to have different grades of dysplastic hips. Among these twelve patients; six of them had a first degree relative with congenital dislocation of hips, three had breech presentation at birth and three had inconclusive clinical findings. Those with dysplastic hips were followed up by serial ultrasound examinations but did not require active intervention. Conclusion: Screening ultrasound is a useful tool for detection of hip dislocation and dysplasia especially among the population of infants at increased risk of developmental dysplasia of the hip. Limitation of screening ultrasound programs for those at risk only reduces the financial burden with better outcome in choosing candidates for further workup especially surgical intervention.

Keywords

• Hip dysplasia
• Screening
• Ultrasonography