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Screening for developmental dysplasia of the hip: current practices in Ireland
M J O'Grady1, G Mujtaba, J Hanaghan
1Department of Paediatrics, Mayo General Hospital, Castlebar, Co, Mayo, Republic of Ireland. michael_ogrady2001@hotmail.com
Insights
Most Irish units use radiographs for hip dysplasia screening, not recommended ultrasound. Experienced neonatal hip examination is infrequent, indicating a need for national guidelines.
Area of Science:
- Pediatric Orthopedics
- Neonatal Care
- Diagnostic Imaging
Background:
- Developmental dysplasia of the hip (DDH) is a common neonatal condition.
- Early detection and treatment of DDH are crucial for optimal outcomes.
- Current screening practices for DDH in the Republic of Ireland were not well-defined.
Purpose of the Study:
- To investigate the current methods used for screening developmental dysplasia of the hip in infants within the Republic of Ireland.
- To evaluate the adherence to best practices in DDH screening.
Main Methods:
- A two-pronged study combining prospective and retrospective approaches.
- Prospective component: Postal questionnaires sent to consultant pediatricians in June 2006.
- Retrospective component: Review of infant radiological follow-up data and outcomes.
Main Results:
- All surveyed maternity units responded, indicating comprehensive coverage.
- Radiographs at 4-6 months were the primary imaging method in 84% of units; ultrasound was used in only 10.5%.
- Less than 30% of routine newborn examinations included a hip examination by an experienced clinician; 94% of radiographs showed normal findings.
Conclusions:
- Widely accepted, effective screening methods like selective ultrasound and experienced clinical examination are not commonly implemented.
- There is a clear need for the development and implementation of national guidelines for DDH screening in Ireland, considering available resources.
Objective:
To ascertain the current approach to screen for developmental dysplasia of the hip in the Republic of Ireland.
Methods:
Two-pronged prospective and retrospective study. (1) Postal questionnaire to consultant paediatricians responsible for the routine neonatal care of infants in the Irish Republic in June 2006. (2) Retrospective database review to identify infants undergoing radiological follow-up and their outcome.
Results:
All maternity units surveyed responded. Most units (84%) were dependent on radiographs at 4-6 months for imaging hips, only two units primarily used ultrasound (10.5%). We estimate that neonatal hip examination is performed by an experienced examiner in less than 30% of routine newborn examinations. On retrospective analysis, 94% of radiographs performed were normal.
Conclusions:
The most effective interventions, selective ultrasound and examination by an experienced clinician are not widely practiced. There is a need for the development of national guidelines based on available resources.
