Universal versus selective ultrasound screening for developmental dysplasia of the hip: a single-centre retrospective...

Area of Science:

• Pediatric Orthopedics
• Diagnostic Imaging
• Public Health Screening

Background:

• Developmental dysplasia of the hip (DDH) requires timely diagnosis and treatment.
• Screening protocols aim to detect DDH early, but optimal strategies remain debated.
• Ultrasound is a primary imaging modality for infant hip screening.

Purpose of the Study:

• To compare universal versus selective ultrasound screening for DDH.
• To evaluate the impact of screening protocols on delayed presentations.
• To assess the effect of screening on subsequent treatment patterns and invasiveness.

Main Methods:

• Retrospective cohort study of 28,068 infants.
• Comparison of outcomes between universal and selective ultrasound screening protocols.
• Analysis of delayed presentation rates, diagnostic errors, and treatment interventions.

Main Results:

• No significant difference in delayed presentation rates between universal and selective screening (all identified cases were administrative errors).
• No sonographic errors (false-negatives) were reported in either group.
• Universal screening resulted in a higher treatment rate but earlier initiation of treatment.
• Infants in the universal screening group were less likely to require surgical intervention, including open reduction or pelvic osteotomy.

Conclusions:

• Universal ultrasound screening for DDH does not reduce delayed presentations but facilitates earlier treatment.
• Early intervention under universal screening protocols decreases the need for complex surgical procedures.
• The findings support the efficacy of universal screening in improving DDH management outcomes.