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Progress in screening strategies for neonatal developmental dysplasia of the hip
Jiuhui Han1, Yu Li2
1Department of Pediatric Orthopaedics, The Third Hospital of Hebei Medical University, Shijiazhuang, China.
Insights
Universal ultrasound screening is recommended for infant developmental dysplasia of the hip (DDH) to improve early detection and prevent late diagnoses. This strategy offers a favorable prevention approach for this common musculoskeletal condition.
Area of Science:
- Pediatric Orthopedics
- Musculoskeletal Diseases
- Neonatal Screening
Background:
- Developmental dysplasia of the hip (DDH) is a common congenital musculoskeletal disorder in newborns.
- Current screening strategies for DDH are debated, with occasional delayed diagnoses or overtreatment.
- Effective screening is crucial for early detection, diagnosis, and treatment of DDH.
Purpose of the Study:
- To analyze the existing literature on developmental dysplasia of the hip screening.
- To evaluate the effectiveness of various DDH screening strategies.
- To provide current opinions on clinical and ultrasound screening methods.
Main Methods:
- Comprehensive literature search of DDH screening studies from 1958 to 2021.
- Utilized MEDLINE and PubMed databases for study retrieval.
- Reviewed historical progress and current controversies in DDH screening.
Main Results:
- Systematic screening has improved DDH detection but faces challenges like delayed diagnoses and overdiagnosis.
- Controversies persist regarding the optimal clinical and ultrasound screening methods.
- Evidence suggests universal ultrasound screening is effective in preventing late-detected cases.
Conclusions:
- Universal ultrasound screening is the most effective strategy for preventing late-detected developmental dysplasia of the hip.
- This approach is recommended as a favorable prevention strategy for newborns.
- Optimizing DDH screening remains critical for improving patient outcomes.
Abstract:
Developmental dysplasia of the hip (DDH) is the most common congenital disease of the musculoskeletal system in newborns and encompasses a disease spectrum ranging from a stable hip with a mildly dysplastic acetabulum to complete hip dislocation. Systematic screening for infant DDH has been performed for several decades all over the world and has contributed greatly to the early detection, diagnosis and treatment of DDH. However, some cases of delayed diagnosis still occur among the screened population, or conversely, overdiagnosis or overtreatment occasionally occurs. Furthermore, screening strategies for DDH are still controversial. The aim of our study was to analyze the current literature on DDH screening, paying particular attention to DDH screening strategies and their effectiveness. We searched the DDH screening literature from 1958 to 2021 in MEDLINE and other databases using PubMed. In this study, we reviewed the history of DDH screening and the progress of screening strategies and discussed the controversies regarding clinical and ultrasound screening methods with particular emphasis on the current opinions. Given the existing scientific evidence and changes in newborn DDH screening practices, universal ultrasound screening seems to be the best option for preventing late-detected cases and can be recommended as a favorable prevention strategy.
