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Radiographic screening at four months of infants at risk for congenital hip dislocation
M Garvey1, V B Donoghue, W A Gorman
1National Maternity Hospital, Dublin, Republic of Ireland.
Insights
Radiographic screening at four months effectively identifies hip abnormalities in at-risk infants. This early detection aids in timely intervention for congenital dislocation of the hip, improving outcomes.
Area of Science:
- Pediatric Orthopedics
- Diagnostic Imaging
Background:
- Congenital dislocation of the hip (CDH) can be missed during neonatal screening.
- Infants with risk factors like family history or breech presentation require further evaluation.
Purpose of the Study:
- To evaluate the efficacy of radiographic hip screening at four months in at-risk infants.
- To determine the incidence of hip abnormalities in this cohort.
Main Methods:
- A two-year screening program identified 357 at-risk infants from 13,662 live births.
- Infants underwent hip radiography at four months of age.
- Abnormal cases were treated or monitored, and normal cases were followed up.
Main Results:
- 46 infants (12.9%) had abnormal radiographs, including subluxation and acetabular dysplasia.
- 12 infants required treatment, while 34 were managed conservatively with follow-up.
- Of 311 infants with normal initial radiographs, 82% showed no abnormalities by 15 months.
Conclusions:
- Four-month radiographic screening is a valuable addition to neonatal assessment for identifying CDH risk.
- Early detection and management of hip dysplasia can lead to favorable outcomes.
Abstract:
We report on a radiographic screening programme at four months of age for infants who were clinically normal at neonatal examination but were considered to be 'at risk' for congenital dislocation of the hip because of their family history, breech presentation, or a persistent click. From a total population of 13,662 live births over a two-year period, 357 (2.6%) infants at risk were identified. Of these 46 had abnormal radiographs (six subluxations, 40 acetabular dysplasia). In 12 infants treatment resulted in a normal hip; 34 required no treatment but were followed up until their radiographs were normal and walking had begun. Of the 311 infants with normal radiographs, 256 (82%) were examined after 15 months of age; none had any detectable abnormality. We suggest that radiography of the hip at four months is a valuable adjunct to neonatal screening for infants at increased risk of congenital dislocation of the hip.