Neonatal hip surveillance and the early management of developmental dysplasia of the hip

Abstract 

Developmental dysplasia of the hip encompasses a range of conditions including acetabular dysplasia and frank dislocation of the hip in infancy, irreducible dislocation at walking age, and early osteoarthritis in adolescence. The earlier the condition is diagnosed and treated the better the prognosis for the hip. Clinical methods of detection in infancy have a low sensitivity which improves with the experience of the examiner, and although ultrasound is the best method for imaging the neonatal hip it does not tell us who to treat and poses logistical problems in organization. Universal screening with ultrasound is probably the best way to detect the condition but is very expensive. Although targeted ultrasound screening programmes for infants with hip instability or risk factors have been criticized, they are more practical for most centres and should be accompanied by clinical screening in the community up to walking age.

Keywords:  Developmental dysplasia of the hip (DDH), Ultrasound, Screening, Surveillance