Ultrasound for Screening and Management of Developmental Dysplasia of the Hip

Fitch, Robert D.

doi:10.18043/ncm.75.2.142

Cited by 11 publications

(15 citation statements)

References 21 publications

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“…Stages IIA and III were diagnosed by ultrasound only for left hips and only in two subjects whose mean weight was 3340 g and, respectively, 3680 g. The existence of only one stage IIA and one case with type III in our study cannot support the supposition that high birth weight is a risk factor for DDH, or that low birth weight (<2500 g) has a protective role for hip developmental dysplasia. [8,30]…”

Section: Discussionmentioning

confidence: 99%

Musculoskeletal ultrasound: a useful tool for diagnosis of hip developmental dysplasia

Mureșan¹,

Mărginean²,

Voidăzan

et al. 2019

Medicine

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Developmental dysplasia of the hip (DDH) is one of the most common congenital abnormalities of the musculoskeletal apparatus in newborns. The aim of this study was to analyze the contribution of ultrasonography in the detection of DDH in newborns and infants, identifying the regional incidence of this pathology in the central area of Romania, emphasizing the risk factors that underlie DDH etiopathogenicity.This article represents a retrospective study of 847 newborns and infants examined in the Imagistic Department of a medical center from the central area of Romania, between January 1 and December 31, 2016. The ultrasound examinations were performed for the bilateral coxofemoral joints, using the method and technique described by Graf. For subjects born in the same medical center, data regarding mother's age, birth weights, and type of delivery (natural vs. caesarian section) were statistically analyzed.In our study group, the frequency of ultrasound diagnosis obtained from the examinations of right and left hips showed that the most frequent stage was type IA, and the rarest stage was III. The IA stage of right coxofemoral joints (87.3%) was higher than in the left coxofemoral joints (87.2%). The incidence of hip dysplasia (type III) diagnosed with ultrasound examinations in subjects from the central area of Romania was 0.2% (0.1% in both hips and 0.1% for the left coxofemoral joint).The musculoskeletal ultrasound examination is effective in early detection of hip dysplasia. The implementation of national and regional programs that promote indications, risk factors, and the screening age for DDH in both rural and urban areas could be a step forward in the early diagnosis of hip dysplasia for newborns and infants. The low incidence of DDH from our study group is not able to identify the role of advanced age of the mother, high birth weight of the newborn, or caesarean section as risk factors involved in the etiology of hip dysplasia. The implementation of national and regional programs that promote the musculoskeletal ultrasound as a screening imagistic investigation for DDH, in both rural and urban areas, could be a step forward in the early diagnosis of hip dysplasia for newborns and infants.

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Section: Discussionmentioning

confidence: 99%

Musculoskeletal ultrasound: a useful tool for diagnosis of hip developmental dysplasia

Mureșan¹,

Mărginean²,

Voidăzan

et al. 2019

Medicine

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“…A meta-analysis by Hundt et al 19 demonstrated that children born with pelvic presentation, female babies, children with positive family history and those who were Ortolani-positive in clinical examination have an increased risk for DDH. Fitch 20 has previously outlined that there is a higher risk for the development of DDH if the disease is present in a first-degree relative, the fetus has breech presentation, the newborn is habitually wrapped in swaddling clothes, or if congenital deformity calcaneal valgus foot is detected. In addition, Fitch 20 noted that clinical screening alone sometimes results in late diagnosis, and the presence of risk factors may trigger the selective use of ultrasound exam.…”

Section: Discussionmentioning

confidence: 99%

“…Fitch 20 has previously outlined that there is a higher risk for the development of DDH if the disease is present in a first-degree relative, the fetus has breech presentation, the newborn is habitually wrapped in swaddling clothes, or if congenital deformity calcaneal valgus foot is detected. In addition, Fitch 20 noted that clinical screening alone sometimes results in late diagnosis, and the presence of risk factors may trigger the selective use of ultrasound exam. This strategy is adopted around the world and seems to be a logical and suitable approach, particularly in places where knowledge regarding DDH is poor, as observed in the present study.…”

Section: Discussionmentioning

confidence: 99%

Developmental Dysplasia of the Hip: Do the Responsible for Screening Know What to Do?

Souza

Melo²,

Resende³

et al. 2016

Acta ortop. bras.

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Objective: To evaluate the knowledge on developmental dysplasia of the hip (DDH) by professionals involved in its diagnosis.Methods: This is a cross-sectional study using questionnaires to assess the knowledge about DDH. Orthopedic surgeons and pediatricians, residents and medical students from a tertiary teaching hospital were included in the study.Results: We evaluated 142 medical students, eight orthopedic residents, ten pediatric residents, seven pediatricians, and nine orthopedic surgeons; 50% declared not having examined any DDH case in the last year and only three had diagnosed more than 10 cases during their career. Regarding self-assessed knowledge (0-10), the average score was 4.25 [n=186; SD=2.43]. Nineteen percent of the participants ignored semiological tests and 26.1% of pediatricians (specialists and residents), were unaware of how to perform them. The most acknowledged and neglected risk factor was pelvic presentation (68%) and CMT (9.3%), respectively. None of the participants were able to identify all the risk factors. The average number of risk factors identified was two (n=186; SD=1.58). Forty seven point three percent of the participants failed to recognize the time of birth as the ideal moment for diagnosis; 17% reported it was after the first month. Regarding neglected severe DDH, 45.3% failed to recognize its natural history.Conclusion: Knowledge on DDH among health professionals who are involved in screening is flawed. Level of Evidence IV, Developing a Decision Model.

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“…If non-surgical treatment begins before the 6 months age the outcome will be successful. On the other hand, delayed diagnosis may result in the complex surgery management [3].…”

Section: Introductionmentioning

confidence: 99%

Comparing the Quality of Life Before and After Total Hip Arthroplasty Operation in Patients With Developmental Dysplasia of the Hip

Sanei

Jamebozorgi

Irani

et al. 2016

PTJ

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Purpose: Developmental dysplasia of the hip (DDH) increases the risk of secondary degenerative changes and subsequent total hip arthroplasty. The postoperative quality of life in patients with DDH who have been born and grown with this disability and adapted to it during the life, is one of the most challenging issues. This study aimed to compare the quality of life of patients with DDH before and after total hip arthroplasty (THA) operation. Methods:This research has a quasi-experimental/interventional design. A group of 20 patients with DDH, who underwent THA operation in Akhtar and Shafa yahyaiyan hospitals, were evaluated before operation and 6 months after it using SF36 quality of life questionnaire. Results:Findings showed significant improvement in all SF-36 subscales scores, including physical function, role physical, role emotional, vitality, mental health, social function, bodily pain, general function, and general health as well as total score (P=0.002). SF-36 mean(SD) scores before and after surgery was 27.41(22.75) and 79.12(28.03), respectively. Conclusion:THA operation improves the quality of life of patients with DDH.

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Ultrasound for Screening and Management of Developmental Dysplasia of the Hip

Cited by 11 publications

References 21 publications

Musculoskeletal ultrasound: a useful tool for diagnosis of hip developmental dysplasia

Musculoskeletal ultrasound: a useful tool for diagnosis of hip developmental dysplasia

Developmental Dysplasia of the Hip: Do the Responsible for Screening Know What to Do?

Comparing the Quality of Life Before and After Total Hip Arthroplasty Operation in Patients With Developmental Dysplasia of the Hip

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