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Pediatricians' Knowledge, Skills, and Practices in Screening for Developmental Dysplasia of the Hip: A Nationwide
Osama M Aldowekat1, Abeer M Aldowikat2, Raeda T Al-Ghananim3
1Department of Pediatric Orthopedics, Children's Hospital of New Orleans, Louisiana State University, New Orleans, Louisiana, USA.
Introduction:
Developmental dysplasia of the hip (DDH) is a common condition that can be effectively treated if detected early. DDH screening remains institution-based with no clear guidelines at the national level in many countries, including Jordan and most of the MENA region. The aim of the study was to assess Jordanian pediatricians' DDH screening knowledge and skills, identify associated factors, and explore readiness for a national screening approach.
Methods:
A nationwide, cross-sectional, STROBE-compliant survey was administered (Aug-Sep 2025) to 255 Pediatricians. A 19-item questionnaire assessed aspects such as risk factors, age of screening, incidence in Jordan, physical signs, confidence in performing the Barlow and Ortolani manoeuvres, and management approaches, along with their 'composite knowledge score' score. CKS was graded using Bloom's cut-offs (high ≥ 80%, moderate 60%-79%, low < 60%). Factors associated with higher CKS were examined with the Welch two-sample t-test, ANOVA and Tukey post hoc tests.
Results:
Only 9% achieved high CKS scores, 49.4% moderate, and 41.6% low. DDH screening was routinely performed by 69.4% of participants, and 70.6% had access to hip ultrasound at their workplace. The mean overall CKS was 61.6 ± 14.6 and the mean CKS scores were 63.3 ± 14.25 for specialists and 57.7 ± 14.78 for residents; Participants with more experience, higher infant exposure, and greater confidence in performing the Barlow and Ortolani manoeuvres achieved higher scores.
Conclusion:
Our study revealed that pediatricians in Jordan generally lack adequate knowledge and skills in DDH screening, a gap consistent across location, sector, and experience level. Higher level of experience, greater exposure to infants and higher confidence in performing Barlow and Ortolani manoeuvres were associated with better proficiency. A national training programme coupled with national guidelines is needed to promote early detection and reduce late-presenting cases.
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