The Ortolani test has a high positive predictive value in clinical hip screening for developmental dysplasia of the...

Area of Science:

• Pediatric Orthopedics
• Neonatal Screening
• Diagnostic Accuracy

Background:

• Developmental dysplasia of the hip (DDH) is a common condition requiring early detection.
• Clinical hip screening tests, including the Ortolani and Barlow maneuvers, are used to identify infants at risk.
• The separate positive predictive values (PPVs) of these tests for predicting hip dysplasia or instability have not been well-established.

Purpose of the Study:

• To determine the positive predictive values of the Ortolani and Barlow tests at discharge in predicting hip dysplasia or instability via subsequent ultrasound examinations.
• To compare the diagnostic accuracy of the Ortolani and Barlow tests in a clinical setting.

Main Methods:

• A retrospective study included infants with suspected or diagnosed DDH from 2015-2017.
• Infants with positive Ortolani or Barlow tests underwent hip ultrasound without initial treatment.
• Positive predictive values were calculated for predicting Graf type ≥ IIC morphology or ≥5 mm displacement on dynamic ultrasound.

Main Results:

• The study analyzed 105 infants with 33 Ortolani-positive and 103 Barlow-positive hips.
• Ultrasound examinations were performed at a mean age of 21.7 days.
• The Ortolani test demonstrated a PPV of 39-61%, while the Barlow test showed a PPV of 4-16% for predicting DDH.

Conclusions:

• The Ortolani test, when performed by a specialist during maternity ward screening, exhibits a high positive predictive value for detecting developmental dysplasia of the hip.
• The Barlow test has a considerably lower positive predictive value, suggesting its findings may require further investigation or confirmation.