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Sensitivity of clinical screening for detecting developmental dysplasia of the hip: a retrospective study
Enrica Pittaluga1, Alexis Arnoux2, Sophie Merckaert2
1Women, Mother and Child Department (DFME), Paediatric Unit, University Hospital Lausanne (CHUV), Lausanne, Switzerland.
Insights
Clinical screening for infant hip dysplasia has limited sensitivity, especially for stable cases. Universal ultrasound screening may improve early detection rates for developmental dysplasia of the hip.
Area of Science:
- Pediatric Orthopedics
- Diagnostic Imaging
- Neonatal Care
Background:
- Early detection of developmental dysplasia of the hip (DDH) in infants is critical for preventing long-term complications.
- Clinical screening is a primary method for identifying DDH, but its diagnostic accuracy requires evaluation.
- Tertiary care settings manage a significant number of DDH cases, offering a valuable cohort for study.
Purpose of the Study:
- To estimate the sensitivity of clinical screening for developmental dysplasia of the hip in infants.
- To compare the diagnostic accuracy of clinical findings against ultrasound results.
- To stratify sensitivity by the severity of developmental dysplasia of the hip.
Main Methods:
- Retrospective evaluation of 122 newborns (0-4 months) diagnosed with DDH.
- Comparison of clinical examinations with hip ultrasound scans using the Graf method.
- Calculation of sensitivity and 95% confidence intervals for clinical findings.
Main Results:
- Overall clinical screening sensitivity for DDH was 66% (95% CI: 58-74%).
- Sensitivity was significantly higher for unstable hips (91%) compared to stable hips (50%).
- Diagnostic timing varied between hip stability groups.
Conclusions:
- Clinical screening for developmental dysplasia of the hip demonstrates limited sensitivity, particularly for stable hip conditions.
- Universal ultrasound screening is suggested to enhance early detection rates for DDH.
- Improved diagnostic strategies are needed for stable DDH cases.
Background:
Detecting developmental dysplasia of the hip in infants is crucial. This study aimed to estimate the sensitivity of clinical screening for developmental dysplasia of the hip in a tertiary care setting. We compared clinical findings with ultrasound results to determine diagnostic accuracy.
Methods:
This retrospective study evaluated newborns aged 0-4 months treated for developmental dysplasia of the hip from May 2017 to June 2023 at a tertiary care centre in Switzerland. All patients underwent clinical examinations and a hip ultrasound scan (Graf method). The sensitivity of clinical findings was calculated, along with 95% confidence intervals (CI), and stratified by developmental dysplasia of the hip severity.
Results:
Among 122 newborns, clinical screening demonstrated an overall sensitivity of 66% (95% CI: 58-74%). Sensitivity was higher for unstable hips (91%, 95% CI: 82-99%) than for stable hips (50%, 95% CI: 38-62%). Differences in diagnostic timing were observed between groups.
Conclusion:
Clinical screening for developmental dysplasia of the hip showed limited sensitivity, particularly for stable cases. Universal ultrasound screening could improve early detection rates.
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