Radiographic Follow-up After Normal Ultrasound Screening of the Hip in Breech Infants

Abstract

Background: Breech presentation is one of the most important risk factors for developmental dysplasia of the hip, and all breech infants should be screened. The necessity of further follow-up of developmental dysplasia of the hip after normal clinical and sonographic screening is a controversial subject. The purpose of this study to identify the incidence of delayed dysplasia in breech infants after normal ultrasound screening and the necessity of further clinical and radiologic follow-up in these patients. Methods: We included the 292 breech babies (128 boys and 164 girls) who showed normal hip ultrasound screening results. To determine the incidence of delayed radiographic dysplasia, anteroposterior hip radiographs were taken between 12 and 24 months of age to measure the acetabular index (AI). Results: The mean AI values were 22.8 ± 3.4 in boys and 24.9 ± 3.1 in girls. Applying the Tönnis criteria, 29 patients (9.9%) were considered to have delayed radiographic dysplasia (16 boys and 13 girls). No significant difference was found in any demographic variables between babies with and without delayed radiographic dysplasia. None of these 29 infants underwent any treatment for radiographic dysplasia. Applying Kuong's criteria to 292 infants, only 2 patients (0.7%) demonstrated radiographic dysplasia on the hip anteroposterior radiographs taken at 14 months. Conclusions: The incidence of radiographic dysplasia significantly varied depending on which criteria were applied. In order to find out more accurate incidence rates of delayed radiographic dysplasia, large-scale studies of the normative AI data for Korean infants are required.

Assessment for late developmental hip dysplasia in a cohort of infants with risk factors and normal hip ultrasound

“…Another US study ( 20 ) reported a prevalence of late DDH of 10%. Recently, a Korean study ( 21 ) demonstrated that among 292 breech infants, two patients (0.7%) had delayed radiographic hip dysplasia at 12–24 months' age after normal ultrasound screening. Pan et al .…”

Outcomes of ultrasound-monitored treatment of divelopmental dysplasia of the hip graf type II

“…Developmental dysplasia of the hip (DDH) has no single causative factor but is considered a multifactorial trait. Familiar positive history, certain racial predisposition, female gender, firstborn children, tweens, breech presentation, oligohydramnios, and presence of other orthopedic problems like postural deformities, foot deformities, torticollis, and other skeletal and muscular abnormalities are widely accepted as proven risk factors (1,2,3). Latest investigations suggest that prematurity is not a risk factor for DDH, but a rather protective factor for hip development (4).…”