Ultrasound screening for congenital dislocation of the hip: a limited targeted programme

Abnormal hips, arising from a clinical universal neonatal hip screening programme, were referred to a specialist paediatric orthopaedic surgeon for ultrasound (US) assessment. Two different methods of US screening were undertaken in consecutive years: (a) Clinically abnormal hips were assessed for dynamic stability without formal assessment of dysplasia; and (b) Morphologic and dynamic assessment was undertaken in clinically abnormal and "at risk" hips. US has been reported as an accurate method for initial diagnosis of instability of the hip joint. The incidence of late congenital dislocation of the hip (CDH) was not reduced by extending the US programme to include "at risk groups" and morphologic assessment of the hips. Morphologic assessment of the hip alone cannot be recommended as a secondary screening programme for the diagnosis of hip dislocation. However, it may be of value in evaluation of persistent dysplasia and its relationship with dislocation. Targeted screening programmes may reduce the rate of late CDH requiring operative procedures; further trials of US are necessary.