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Developmental dysplasia in male infants: risk factors, instability and ultrasound screening
Pinar Koşar1, Elif Ergun, Hasan Yiğit
1Department of Radiology, Ankara Training and Research Hospital, Ankara, Turkey.
Insights
Risk factors do not significantly predict developmental dysplasia of the hip (DDH) in male infants. Selective ultrasound screening may miss cases, so assessing all male infants is recommended.
Area of Science:
- Pediatric Orthopedics
- Diagnostic Imaging
- Neonatal Screening
Background:
- Developmental dysplasia of the hip (DDH) is a condition affecting hip joint development in infants.
- Identifying risk factors and optimizing screening protocols are crucial for early detection and intervention.
Purpose of the Study:
- To investigate the association between risk factors and DDH in male infants.
- To compare the effectiveness of different ultrasound (US) screening strategies for DDH.
Main Methods:
- A study included 1321 male infants undergoing hip ultrasound.
- Combined Graf static and Harcke dynamic ultrasound methods were used.
- Chi-square and Fisher's exact tests analyzed risk factors and DDH progression.
Main Results:
- The incidence of DDH was 1.4%, with a 1.8% treatment rate.
- No statistically significant risk factor was linked to DDH.
- 28% of DDH cases lacked identifiable risk factors, suggesting missed diagnoses with selective screening.
Conclusions:
- Risk factors are not statistically significant predictors of DDH in male infants.
- Selective ultrasound screening may miss a substantial proportion of DDH cases.
- Universal hip ultrasound screening for all male infants is recommended.
Objective:
To evaluate the relationship between risk factors and presence of developmental dysplasia of the hip (DDH) in male infants, and to compare the efficiency of different ultrasound (US) screening protocols.
Materials And Methods:
1321 male infants were included in the study. Ultrasound examinations were performed by combining Graf's static method and Harcke's dynamic method. The relationship between the risk factors and DDH and the effect of risk factors on sonographic worsening in type 2a hips were assessed by the chi-square test and Fisher`s exact test.
Results:
The incidence of DDH was 1.4%. 13% of the cases had type 2a morphology, among whom in 3.1% sonographic deterioration occurred. The treatment rate was 1.8%. The rate of follow-up US was 17.5%. No risk factor was found to have a statistically significant influence on DDH (= type 2b morphology). Among the 32 cases with DDH, 23(72%) had a risk factor or positive clinical finding while 9(28%) did not (p:0.006).
Conclusion:
Risk factors do not have a statistically significant relationship with DDH in male cases. In our study 28% of the cases with DDH would be missed by a selective US screening protocol. We recommend assessment of all male infants with hip US.
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