Related Experiment Video
Updated: Mar 30, 2026
In Vivo Quantification of Hip Arthrokinematics during Dynamic Weight-bearing Activities using Dual Fluoroscopy
Published on: July 2, 2021
Delayed diagnosis of developmental dysplasia of the hip in Northern Ireland: can we do better?
K J Donnelly1, K W Chan1, A P Cosgrove1
1Musgrave Park Hospital, Stockman's Lane, Belfast, Northern Ireland BT9 7JB, UK.
Insights
Early diagnosis of developmental dysplasia of the hip (DDH) is crucial. In Northern Ireland, a four-month health visitor check could identify more DDH cases earlier, reducing late diagnoses.
Area of Science:
- Pediatric Orthopedics
- Public Health Screening
Background:
- Developmental dysplasia of the hip (DDH) requires early diagnosis for optimal outcomes.
- Current UK screening includes checks at birth and six weeks; Northern Ireland adds a four-month health visitor assessment.
- Late presentations of DDH, beyond one year, suggest missed opportunities for earlier detection.
Purpose of the Study:
- To investigate the potential for earlier diagnosis in children with late-presenting DDH in Northern Ireland.
- To evaluate the effectiveness of the existing selective screening program and inform the debate on screening strategies.
Main Methods:
- Retrospective review of DDH patients born in Northern Ireland between 2008-2010, diagnosed after their first birthday.
- Analysis of screening program effectiveness and potential for earlier detection based on clinical signs.
- Minimum follow-up of four years and six months to identify late presentations.
Main Results:
- Out of 75,856 live births, 645 children (8.5 per 1000) were treated for DDH.
- 32 children (33 hips, 0.42 per 1000) were diagnosed with DDH after their first birthday.
- An estimated 65.6% of these late-diagnosed cases had potential for earlier identification through the screening program.
Conclusions:
- The findings support the continuation of the four-month health visitor check, as a peak in DDH diagnosis occurred between three and five months.
- Optimizing the selective screening program could significantly reduce the incidence of late DDH diagnoses.
- The study contributes evidence to the ongoing discussion regarding selective versus universal screening for DDH.
Abstract:
Developmental dysplasia of the hip (DDH) should be diagnosed as early as possible to optimise treatment. The current United Kingdom recommendations for the selective screening of DDH include a clinical examination at birth and at six weeks. In Northern Ireland babies continue to have an assessment by a health visitor at four months of age. As we continue to see late presentations of DDH, beyond one year of age, we hypothesised that a proportion had missed an opportunity for earlier diagnosis. We expect those who presented to our service with Tonnis grade III or IV hips and decreased abduction would have had clinical signs at their earlier assessments. We performed a retrospective review of all patients born in Northern Ireland between 2008 and 2010 who were diagnosed with DDH after their first birthday. There were 75 856 live births during the study period of whom 645 children were treated for DDH (8.5 per 1000). The minimum follow-up of our cohort from birth, to detect late presentation, was four years and six months. Of these, 32 children (33 hips) were diagnosed after their first birthday (0.42 per 1000). With optimum application of our selective screening programme 21 (65.6%) of these children had the potential for an earlier diagnosis, which would have reduced the incidence of late diagnosis to 0.14 per 1000. As we saw a peak in diagnosis between three and five months our findings support the continuation of the four month health visitor check. Our study adds further information to the debate regarding selective versus universal screening.
More Related Videos
08:40Author Spotlight: A Novel 3D-Printed Titanium Implant for Minimally Invasive Treatment of Hip Dysplasia in Young Dogs
Published on: April 19, 2024
09:51The Transition to an Anterior-Based Muscle Sparing Approach Improves Early Postoperative Function but is Associated with a Learning Curve
Published on: September 7, 2022