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Updated: Aug 8, 2026
A Novel Application of Musculoskeletal Ultrasound Imaging
Published on: September 17, 2013
[Initial results of the evaluation study of ultrasound hip screening in Germany]
K P Günther1, S Stoll, A Schmitz
1Orthopädische Klinik, Universität Ulm (RKU).
Insights
Universal ultrasound screening for developmental dysplasia of the hip (DDH) in Germany has not yet eliminated late diagnoses. Continued evaluation is needed to determine if screening effectiveness improves over time.
Area of Science:
- Pediatric Orthopedics
- Diagnostic Imaging
- Public Health Screening
Background:
- Developmental dysplasia of the hip (DDH) is a condition requiring early detection and intervention.
- Germany established a universal sonographic screening program for DDH in 1996.
- Assessing the real-world effectiveness of this screening program is crucial.
Purpose of the Study:
- To evaluate the effectiveness of the universal sonographic screening for developmental dysplasia of the hip (DDH) implemented in Germany.
- To determine the incidence of inpatient treatment for DDH post-screening implementation.
Main Methods:
- A national survey was conducted between May and October 1997.
- Pediatric orthopedic surgeons reported inpatient cases of DDH in children aged 10 weeks to 5 years.
- Data collected included treatment modalities and timing/results of prior ultrasound screening.
Main Results:
- 129 children underwent surgical treatment for DDH during the study period.
- Ultrasound screening was performed too late or not at all in 35.1% of cases.
- The unadjusted incidence of inpatient DDH treatment was calculated at 0.33 per 1000 livebirths.
Conclusions:
- DDH cases requiring surgical intervention continue to be identified despite the universal ultrasound screening program.
- Further long-term evaluation is necessary to ascertain if the screening program leads to a reduction in DDH incidence.
- The study highlights potential gaps in the timely and universal application of hip ultrasound screening.
Aim Of Study:
To assess the effectiveness of a universal sonographic screening of developmental dysplasia of the hip (DDH) established in Germany since 1996.
Methods:
Currently a national survey is being performed in Germany to identify infants and young children who receive inpatient treatment for DDH. Between May, 1997 and October, 1997 monthly questionnaires were sent to all pediatric orthopaedic surgeons (active surveillance) and they were asked to report all inpatient cases between 10 weeks of age and 5 years with current closed or open reduction and/or osteotomies due to DDH. Information on time and results of previous ultrasound screening as well as treatment modalities was obtained in reported cases.
Results:
129 children (mean age at hospital admission 15.9 months, range 1.1 to 57.1 months) underwent closed reduction (n = 51), open reduction (n = 40) and osteotomies of the hip (n = 38) in the 6-month study period. Ultrasound screening has been performed too late and not at all in 45 children (35.1%). While in 18 cases (13.7%) no information could be obtained on screening results, the majority of children (n = 66, 51.2%) had completed DDH screening prior to the sixth week of life as recommended. Preliminary calculation of the unadjusted incidence of inpatient treatment for DDH in Germany was 0.33 per 1000 livebirths.
Conclusion:
DDH cases are still identified after introduction of an universal ultrasound hip screening in Germany. Continued evaluation must show, whether the incidence will decrease throughout the next few years.
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