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[Correlation of pathological clinical hip symptoms in the sonographic study of infant hips]
Insights
Clinical examination of infant hip dysplasia is crucial. The Roser-Ortolani and Hilgenreiner signs show high specificity for infant hip dysplasia, unlike less specific signs like limited hip abduction.
Area of Science:
- Orthopedics
- Pediatric Radiology
- Developmental Dysplasia of the Hip
Background:
- Infant hip dysplasia diagnosis relies on clinical signs and sonographic screening.
- The diagnostic value of various clinical signs requires further clarification.
Purpose of the Study:
- To evaluate the diagnostic accuracy of clinical signs for infant hip dysplasia.
- To determine the specificity of the Roser-Ortolani and Hilgenreiner signs compared to other clinical findings.
Main Methods:
- A retrospective study of 6532 infant hips examined clinically and sonographically between 1984 and 1990.
- Analysis of sonographic hip findings in relation to specific clinical signs, including the Roser-Ortolani sign, Hilgenreiner sign, and limitation of hip abduction.
- Classification of hip pathology using the Graf method.
Main Results:
- Sonographic hip abnormalities were found in 71.7% of hips with a positive Roser-Ortolani sign and 100% with a positive Hilgenreiner sign.
- Only 18% of hips with limited abduction showed pathological Graf types.
- The Roser-Ortolani and Hilgenreiner signs demonstrated high specificity for infant hip dysplasia.
Conclusions:
- The Roser-Ortolani and Hilgenreiner signs are highly specific indicators of infant hip dysplasia.
- Clinical signs such as limited hip abduction are less specific for diagnosing infant hip dysplasia.
- Sonographic screening remains important for confirming diagnoses suggested by specific clinical findings.
Abstract:
The relevance of clinical signs of infant hip dysplasia and the importance of a sonographic newborn-hip screening are often discussed. Between 1984 and 1990 at our department 6532 infant hips were examined both clinically and sonographically. Sonographic hip findings were pathological in 71.7% of the hips with positive clinical Roser-Ortolani sign and in 100% of the hips with positive Hilgenreiner sign. In contrast, pathological hip types according to Graf were seen only in 18% of the hips with limitations of the abductions of the hip joint. Examining other clinical signs for infant hip dysplasia within this study, as well we can conclude, that only the Roser-Ortolani sign and that of Hilgenreiner showed a high specificity for infant hip dysplasia, while most of the clinical signs e.g. limitation of abduction in the hip joint are rather unspecific.