“…Barlow identified the lack of usefulness of this finding and subsequent studies showed that one-third of a cohort of 500 neonates had asymmetrical hip creases and 27% had no thigh skinfolds [10]. Only two of the infants in this group had an abnormal provocative test of hip stability.…”
The most effective interventions, selective ultrasound and examination by an experienced clinician are not widely practiced. There is a need for the development of national guidelines based on available resources.
“…Barlow identified the lack of usefulness of this finding and subsequent studies showed that one-third of a cohort of 500 neonates had asymmetrical hip creases and 27% had no thigh skinfolds [10]. Only two of the infants in this group had an abnormal provocative test of hip stability.…”
The most effective interventions, selective ultrasound and examination by an experienced clinician are not widely practiced. There is a need for the development of national guidelines based on available resources.
“…Additional physical signs previously considered to be associated with DDH, including asymmetrical thigh and gluteal skin folds, have little value in diagnosis 14 15 20 24…”
This study identifies a time-dependent association with unilateral LHA in the diagnosis of 'pathological' DDH after the age of 8 weeks. The presence of bilateral LHA in the young infant may be a normal variant and is an inaccurate clinical sign in the diagnosis of pathological DDH. LHA should be actively sought after 8 weeks of age and if present should be followed by a formal ultrasound or radiographic examination to confirm whether or not the hip is developing in a satisfactory manner.
“…No study has addressed the comparative value of ultrasound to radiograph. However, there is strong endorsement of the superiority of ultrasound in the early months of life in the literature, ranging from historical studies reporting on timing of ossification and analyzing the technical challenges of hip radiography in the young infant 63,73 to contemporary systematic reviews. 1,4 However, ultrasound screening is not without its shortcomings.…”
Section: Use Of Imaging To Screen For Ddhmentioning
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