Objectives To evaluate the accuracy of measurement of the pubofemoral distance (PFD) for the diagnosis of developmental dysplasia of the hip (DDH), using the Graf method as the reference standard. Methods This was a prospective diagnostic accuracy study evaluating 1980 hips in at‐risk neonates. The PFD measurement and the Graf method were performed at the same opportunity, with the hips in the same position (slightly flexed, adducted, and medially rotated). Results In our sample, the prevalence of DDH, defined as Graf type IIb or higher, was 15.6%. The mean PFD for dysplastic hips was 3.5 mm (median, 3.3 mm), whereas it was 3.0 mm (median, 2.9 mm) for nondysplastic hips. In both groups, there was a significant overlap between the PFD measurements and the Graf classifications. The PFD cutoff with the largest area under the receiver operating characteristic curve was 3.0 mm, which was found to have a sensitivity and specificity of 63.6 and 62.2%, respectively, with positive and negative predictive values of 31.2 and 71.4%, respectively, for the diagnosis of DDH. Conclusion Measurement of the PFD shows good overall accuracy for the diagnosis of DDH. However, given its low‐positive predictive value, it should not be considered to be a replacement for the Graf method.

Resumo Objetivo Avaliar a prevalência de displasia de desenvolvimento de quadril (DDQ), ou seja, quadris de tipo de Graf IIc ou maior, em amostra da população de recém-nascidos de 0 a 3 dias de vida, e correlacionar os achados com os principais fatores de risco descritos na literatura. Métodos Estudo observacional, transversal e prospectivo em amostra de recém-nascidos, em um hospital maternidade em São Paulo, para avaliar a prevalência da DDQ diagnosticada pelo método de Graf e verificar sua correlação com os fatores de risco. Resultados Um total de 678 recém-nascidos foram submetidos a ultrassonografia de quadril (1.356 quadris). A prevalência de DDQ (quadris tipo IIc, D, IIIa, IIIb, e IV de Graf) foi de 5,46%. A análise de regressão logística mostrou razões de chances (RCs) com significância estatística para os parâmetros etnia branca (RC = 2.561; intervalo de confiança de 95% [IC95%]: 1,07 a 6,11), multiparidade (RC = 3,50; IC95%: 1,62 a 7,38), sexo feminino (RC = 4,95; IC95%: 1,86 a 13,13), e apresentação pélvica (RC = 2,03; IC95%: 1,01 a 4,11). Conclusão A prevalência de DDQ na amostra foi de 5,45% usando a ultrassonografia como método de diagnóstico. Este resultado é diferente do dos estudos que avaliam a prevalência exclusivamente do exame físico (manobra de Ortolani). Os principais fatores de risco associados ao maior risco de DDQ foram recém-nascidos do sexo feminino, com apresentação pélvica, primogênitos, e de etnia branca.

BACKGROUND: Developmental dysplasia of the hip (DDH) encompasses a broad spectrum of hip pathologies, including femoral or acetabular dysplasia, hip instability, or both. According to the medical literature, ultrasonography is the most reliable diagnostic method for DDH. Several techniques for the assessment of hips in newborns and infants, using ultrasonography, have been described. OBJECTIVE: To compare the accuracy of the Graf technique and other diagnostic techniques for DDH. DESIGN AND SETTING: A systematic review of studies that analyzed ultrasound techniques for the diagnosis of DDH within an evidence-based health program of a federal university in São Paulo (SP), Brazil. METHODS: A systematic search of relevant literature was conducted in the PubMed, EMBASE, Cochrane Library, CINAHL, and LILACS databases for articles published up to May 5, 2020, relating to studies evaluating the diagnostic accuracy of different ultrasound techniques for diagnosing DDH. The QUADAS 2 tool was used for methodological quality evaluation. RESULTS: All hips were analyzed using the Graf method as a reference standard. The Morin technique had the highest rate of sensitivity, at 81.12-89.47%. The Suzuki and Stress tests showed 100% specificity. The Harcke technique showed a sensibility of 18.21% and specificity of 99.32%. CONCLUSION: All the techniques demonstrated at least one rate (sensibility and specificity) lower than 90.00% when compared to the Graf method. The Morin technique, as evaluated in this systematic review, is recommended after the Graf method because it has the highest sensitivity, especially with the three-pattern classification of 89.47%. REGISTRATION NUMBER: Identifier: CRD42020189686 at the International Prospective Register of Systematic Reviews (identifier: CRD42020189686).

Resumo Objetivo Avaliar se a aplicação das escalas subjective elbow value (SEV) e Patient-rated Tennis Elbow Evaluation (PRTEE) apresentam resultados similares na avaliação de pacientes com epicondilite lateral do cotovelo. Métodos Trinta e sete indivíduos com diagnostic de epicondilite lateral do cotovelo foram avaliados no ambulatório de cirurgia do ombro e cotovelo do nosso hospital. O diagnóstico foi realizado com a história clínica da patologia, exame físico, raio-x, e ultrassonográfia. Foram utilizadas as escalas SEV e PRTEE, e os resultados foram comparados estatisticamente, usando-se como nível de significância 5% (p ≥ 0,05). Resultados Encontramos uma relação estatisticamente significante entre os valores obtidos pelas escalas SEV e PRTEE quando aplicadas no grupo de pacientes portadores de epicondilite lateral (p = 0,017). Conclusão Subjective elbow value apresentou resultados similares ao PRTEE na avaliação de pacientes com diagnóstico de epicondilite lateral do cotovelo.