scholarly journals Early detection of developmental dysplasia of hip by ultrasound

2019 ◽  
pp. 112070001987968 ◽  
Author(s):  
Zita Gyurkovits ◽  
Gellért Sohár ◽  
Anna Baricsa ◽  
Gábor Németh ◽  
Hajnalka Orvos ◽  
...  
Keyword(s):  
Risk Factors ◽  
Positive Family History ◽  
Breech Presentation ◽  
Female Gender ◽  
Developmental Dysplasia ◽  
Developmental Dysplasia Of Hip ◽  
Graf Method ◽  
Hip Ultrasound ◽  
A Prospective Study ◽  
Dysplasia Of The Hip

Objective: To assess the effectiveness of early universal ultrasound (US) screening of developmental dysplasia of the hip (DDH). Study design: A prospective study of universal hip screening of all mature neonates was conducted from 2012 to 2013, at the Department of Obstetrics and Gynaecology, University of Szeged; 1636 newborns (3272 hips) had clinical examinations and hip ultrasound by the Graf method within the1st 3 days of life. Prevalence of DDH, risk factors, sensitivity and specificity of clinical examinations were evaluated. Results: At the 1st US, 70 of the examined 3272 hips (2.14%) were found to be positive. According to Graf categories, the following distribution was observed: type II C, 21 hips (30.0%); D, 24 hips (34.28%); III, 24 hips (34.28%); IV, 1 hip (1.44%). Regarding the risk factors, female gender, breech presentation and positive family history proved to be significant. Interestingly, 28 (50.90%) of the 55 newborns with DDH had neither positive physical signs nor any risk factors, except being female. The physical examination was calculated for sensitivity (20.0%) and specificity (98.34%). Conclusions: In our 1-year period study, 50.9% of the newborns with DDH had neither any positive physical signs nor any risk factors, except being a female. In contrast, early universal US screening of the hip facilitated to diagnose all cases with hip dysplasia. Hip sonography is an effective mode of prevention in orthopaedics, however further studies are needed to compare the rates of operative procedures in selective versus universal screening models.

Developmental dysplasia of the hip and associated risk factors in Saudi children: A retrospective study

2021 ◽  
pp. 1-8
Author(s):  
Alaa I. Ibrahim ◽  
Eman M. Mortada ◽  
Saeed Abdullah Alqahtani ◽  
Haya Alkathri ◽  
Rania Alsayyed ◽  
...  
Keyword(s):  
Risk Factors ◽  
Family History ◽  
Positive Family History ◽  
Hip Dislocation ◽  
Breech Presentation ◽  
Female Gender ◽  
Developmental Dysplasia ◽  
P Values ◽  
Dysplasia Of The Hip ◽  
Associated Abnormalities

BACKGROUND: Studies investigating the association between developmental dysplasia of the hip (DDH) and risk factors in Saudi Arabia are rare. OBJECTIVE: Investigate the association between DDH and several risk factors among Saudi children. METHODS: The medical records of 82 children born in or admitted to King Abdul Aziz Medical City in Riyadh, Saudi Arabia with clinical suspicion of hip dislocation (HD) were included. The association between DDH and the following risk factors was investigated: age < 3 y, female-gender, twinning, first-born child, C-section, breech presentation, prematurity, positive family history and presence of associated abnormalities. RESULTS: HD was confirmed in 73 (89%) children (Positive HD) and excluded in 9 (11%) children (Negative HD). Eleven (13.4%) children were excluded from the positive cases as it was confirmed that they have paralytic hip dislocation not DDH. DDH was confirmed in 62 children (75.6%). The Chi square test (χ2) and odds ratios (OR) revealed that the positive family history, female-gender, age < 3 years, and presence of associated abnormalities had significant associations with the presence of DDH with P values and OR equal 0.00 (16.4), 0.002 (3.1), 0.005 (2.6), and 0.04 (1.9) respectively. Breech presentation, twinning, first-born children, prematurity, and C-section were not associated with DDH with P values and OR equal 0.93 (1.1), 0.46 (0.4), 0.11 (0.4), 0.08 (0.3), and 0.002 (0.3) respectively. CONCLUSIONS: Positive family history, female-gender, age < 3 years, and presence of associated abnormalities had approximately 16, 3, 2.5, and 2 times increased risk for DDH.

scholarly journals Associations between risk factors and developmental dysplasia of the hip and ultrasonographic hip type: a retrospective case control study

2019 ◽  
Vol 13 (2) ◽  
pp. 161-166 ◽  
Author(s):  
H. Ömeroğlu ◽  
A. Akceylan ◽  
N. Köse
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Family History ◽  
Hip Dysplasia ◽  
Positive Family History ◽  
Significant Risk ◽  
Breech Presentation ◽  
Developmental Dysplasia ◽  
Type I ◽  
Dysplasia Of The Hip

Purpose We aimed to revisit the correlation between the previously defined risk factors and the occurrence of developmental dysplasia of the hip (DDH) and to assess the influence of these factors on the ultrasonographic type of hip dysplasia according to the Graf’s classification in patients with DDH. Methods Data of healthy infants (mean age 33 days) who had bilateral mature (normal) hips (Graf type I) were compared with the data of infants (mean age 105 days) who were treated by abduction brace due to unilateral or bilateral DDH (Graf type IIa- and worse hips). Results Infants with at least one risk factor had a significantly higher rate of DDH than those with no risk factors (p < 0.001). Likewise, infants with more than one risk factor had a significantly higher rate of DDH than those with only one risk factor (p = 0.008). Family history, breech presentation and swaddling were found to be the three significant risk factors related to the development of DDH. Family history, swaddling and oligohydramnios were found to be the three significant risk factors correlated with a higher rate of unstable/decentred hip(s) (Graf types D/III/IV) in patients with DDH. Conclusion The risk of DDH significantly increases in infants who have more than one risk factor for DDH. Positive family history and postnatal traditional swaddling are the two main factors both in the aetiology of DDH and in development of a more severe hip dysplasia in patients with DDH. Besides, breech presentation increases the risk of development of DDH and oligohydramnios leads to development of a more severe hip dysplasia in patients with DDH. By introducing these four variables as ‘absolute risk factors for DDH’ to the selective newborn hip screening programmes, the sensitivity and specificity of these programmes may be optimized and the risk of delayed diagnosis may be lessened. Level of Evidence Level III prognostic study

scholarly journals Risk Factor Assessment and a Ten-Year Experience of DDH Screening in a Well-Child Population

2019 ◽  
Vol 2019 ◽  
pp. 1-6 ◽  
Author(s):  
Bahar Kural ◽  
Esra Devecioğlu Karapınar ◽  
Pınar Yılmazbaş ◽  
Tijen Eren ◽  
Gülbin Gökçay
Keyword(s):  
Risk Factors ◽  
Multiple Pregnancy ◽  
Breech Presentation ◽  
Clinical Findings ◽  
Developmental Dysplasia ◽  
Control Group ◽  
Case Group ◽  
Retrospective Case ◽  
Female Sex ◽  
Dysplasia Of The Hip

Aim. Risk based screening for developmental dysplasia of the hip (DDH) with ultrasound is common. However, risk factors vary from one country to the other since data are insufficient to give clear recommendations. We aimed to evaluate the risk factors for developmental dysplasia of the hip (DDH). Methods. In this retrospective case-control study, the health records of all children, who were followed up between 2004 and 2014 at a well-child unit, were investigated for the diagnosis of DDH in Turkey. Of 9758 children, 57 children were found to have abnormal ultrasonographic findings (according to Graf classification) and these constituted the case group. As the control group, healthy 228 children who matched the case children in birth months were selected. Two groups were compared for the risk factors. Results. A total of 19516 hips of 9758 children were examined for DDH. 97 hips of 57 children were found to have abnormal ultrasonographic findings. When the two groups were compared, breech presentation, multiple pregnancy, and torticollis were identified as risk factors. The female sex was also found to have a significantly high prevalence among the children in the case group. Limited hip abduction, positive Ortolani, and Barlow signs were important clinical findings in the case group. Conclusion. According to our findings, breech presentation, female sex, torticollis, and multiple pregnancy were found to be the risk factors of this disorder. Infants with these risk factors should be investigated carefully for DDH.

scholarly journals Role of arthrography in assessing the closed reduction in treatment of DDH.

2019 ◽  
Vol 26 (12) ◽  
pp. 2184-2187
Author(s):  
Khawar Shahzad ◽  
Rana Dawood Ahmad Khan ◽  
Sajjad Iqbal ◽  
Mazhar Mehmood ◽  
Beenish Israr ◽  
...  
Keyword(s):  
Closed Reduction ◽  
Positive Family History ◽  
Breech Presentation ◽  
Ligamentum Teres ◽  
Developmental Dysplasia ◽  
Musculoskeletal Problems ◽  
Study Setting ◽  
Dysplasia Of The Hip ◽  
Normal Head

Developmental dysplasia of the hip (DDH) is one of the most common musculoskeletal problems in newborns. It occurs in 1in 1000 live births affecting girls more than boys and more associated with breech presentation and positive family history. Objectives: To evaluate the effectiveness of arthrography in assessing the closed reduction of DDH. Study Design: Clinicial Study. Setting: This study was conducted at Allied Hospital, Faisalabad, Pakistan, Period: From December 2013 to January 2016 and comprised patients of either gender. Material & Methods: DDH was diagnosed with help of clinical examination and radiological investigations. Arthrography was performed and images were taken in different positions of the hip which were evaluated and findings noted. Results: Out of 50 hips, 34 had normal looking head of femur while 16 patients had head of femur which was either smaller than normal or of abnormal shape. Shape of acetabulum was found normal in 41 hips. Normal labrum was present in 44, inverted in 4 and everted in 2 patients. Ligamentum teres was found hypertrophic in 6 patients. Normal head coverage was present in 40 while in 10 hips head of femur was lateralized ≥ 4 mm. No external obstruction to reduction was encountered. In 44 cases reduction was concentric and eccentric reduction was noted in 6 patients. Conclusion: Arthrography is of special help in assessing the reduction of hip in DDH as it provides information about shape of head of femur, shape of acetabulum, labrum, ligamentum teres, containment of the hip, coverage of head and external obstacles to reduction.

Value of the ‘clicky hip’ in selective screening for developmental dysplasia of the hip

2019 ◽  
Vol 101-B (6) ◽  
pp. 635-638 ◽  
Author(s):  
B. A. Marson ◽  
J. B. Hunter ◽  
K. R. Price
Keyword(s):  
Risk Factors ◽  
Hip Dysplasia ◽  
Screening Programme ◽  
Developmental Dysplasia ◽  
Selective Screening ◽  
Ultrasound Scan ◽  
Additional Risk ◽  
Hip Ultrasound ◽  
Dysplasia Of The Hip ◽  
Prospective Database

Aims The aim of this study was to review the value of accepting referrals for children with ‘clicky hips’ in a selective screening programme for hip dysplasia. Patients and Methods A single-centre prospective database of all referrals to the hip clinic was examined to identify indication for referrals, diagnosis, and treatment. All patients referred received a standardized ultrasound scan and clinical examination by an orthopaedic consultant. Results There were 5716 children referred to the orthopaedic hip clinic between 1 June 2014 and 26 September 2018. In all, 1754 children (30.1%) were referred due to ‘clicky hip’ with no additional risk factors or indications for ultrasound scan. A total of 123 children (7.1%) referred with ‘clicky hip’ and no additional risk factors or examination findings had an abnormal initial hip ultrasound, including 16 children (0.9%) with dysplastic hips. Of the 141 children who required treatment in a Pavlik harness during the study period, 23 (16%) had been referred with a ‘clicky hip’ and no additional risk factors or examination findings, including six children with Graf 3 or 4 hips. Conclusion There is significant value in reviewing children with an isolated ‘clicky hip’. Many children who require treatment are referred to the orthopaedic service as ‘clicky hip’ with no additional risk factors. In a pragmatic pathway with a diverse population of clinicians performing baby checks, ‘clicky hip’ is an important indication for referral and should not be discarded. Cite this article: Bone Joint J 2019;101-B:635–638.

scholarly journals Impact of Multiple Factors on the Incidence of Developmental Dysplasia of the Hip

2021 ◽  
Author(s):  
Łukasz Pulik ◽  
Krzysztof Romaniuk ◽  
Aleksandra Sibilska ◽  
Andrzej Jedynak ◽  
Ignacy Tołowiński ◽  
...  
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Positive Family History ◽  
Developmental Dysplasia ◽  
Risk Calculator ◽  
The Impact ◽  
Dysplasia Of The Hip

Abstract Introduction: Developmental dysplasia of the hip (DDH) is one of the most common musculoskeletal conditions in children. Not treated DDH leads to disability, gait abnormalities, limb shortening and chronic pain. Our study aims to determine the impact of multiple risk factors on the occurrence of DDH and develop an interactive risk assessment tool.Methods: We conducted a retrospective cohort study in the Outpatient Clinic for Children of University Hospital. The Graf classification system was used for ultrasonographic universal screening. In total, 4881 infants met the eligibility criteria (n = 9762 hip joints). Hypothesis testing was performed with χ² test and logistic regression.Results: The incidence of DDH was 4.57%. We have proven risk factors of DDH: female gender (OR=7.11), breech position (OR=3.65), Caesarean section (OR=1.43), positive family history in parent (OR=1.92) or sibling (OR=3.84). Preterm delivery decreased the risk (OR=0.17). Logistic regression was used to construct the interactive risk calculator.Conclusion: The DDH risk calculator was built but needs external validation in prospective study before being used in a clinical setting. We confirmed well-known DDH risk factors in the studied population. Our results support the recent hypothesis that preterm infants (37 < week) have lower rate of DDH.Level of Evidence:Retrospective cohort study: Level III

scholarly journals Ultrasonography of Borderline and Asymmetric Infant Hips - a Challenge in the Management of Developmental Dysplasia of the Hip

2018 ◽  
Vol 91 (4) ◽  
pp. 422-426
Author(s):  
Dan Vasilescu ◽  
Dan Cosma ◽  
Dana Elena Vasilescu ◽  
Carolina Maria Solomon ◽  
Andrei Corbu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Developmental Dysplasia ◽  
Clinical Suspicion ◽  
Radiology Department ◽  
Healthy Population ◽  
Imaging Method ◽  
Graf Method ◽  
Group Ii ◽  
Α Angle ◽  
Dysplasia Of The Hip

Background and aim. Developmental dysplasia of the hip (DDH) is a potentially disabling disease. There are many diagnostic approaches, Graf method ultrasonography being the most popular imaging method. Although considered as a healthy condition, the existence of hips at the 60 degree limit or the asymmetries higher than 4 degrees between left and right side may be a source of unfavorable evolution and consequently of late diagnosed dysplasia cases.Methods. The retrospective study was conducted in the Radiology Department of the Emergency Clinical County Hospital Cluj-Napoca, by retrospective analysis of the database containing 3013 records of the subjects presented for DDH assessment between January 2008 and December 2014. The study focuses on investigating two possible sources of missed cases by clinical-ultrasound management of DDH: borderline and asymmetric hips. Two conditions were studied in patients considered healthy according to Graf method: borderline hips (those with α angle value of 60° and 61°) and asymmetric hips (left to right difference between the α angle values exceeds 4°). Three study groups were formed: healthy subjects, asymmetric/borderline subjects and patients with immature or mild dysplasia. The incidence of risk factors, clinical suspicion and the success of therapy were evaluated.                Results. There were no significant differences between the three groups regarding the role of the risk factors in DDH pathogenesis. Data reveal a high suspicion rate after the clinical examination, in groups II and III, compared to the healthy population. This means that from this point of view, Group II might be considered having at least a dysplastic prognosis. An increased correlation in the therapeutic results was observed between Group II patients and those from mild delayed maturation subgroups from Group III (IIa-, IIa+).Conclusions. Asymmetric and borderline hips should be approached similarly to immature hips, clinical suspicion and the therapeutic outcome being similar.

scholarly journals Developmental dysplasia of the hip

2010 ◽  
Vol 2 (2) ◽  
pp. 19 ◽  
Author(s):  
Shahryar Noordin ◽  
Masood Umer ◽  
Kamran Hafeez ◽  
Haq Nawaz
Keyword(s):  
Positive Family History ◽  
Breech Presentation ◽  
Developmental Dysplasia ◽  
Diagnostic Methods ◽  
Careful Examination ◽  
First Year ◽  
Older Children ◽  
Hip Abduction ◽  
First Year Of Life ◽  
Dysplasia Of The Hip

Developmental dysplasia of the hip (DDH) is a spectrum of anatomical abnormalities of the hip joint in which the femoral head has an abnormal relationship with the acetabulum. Most studies report an incidence of 1 to 34 cases per 1,000 live births and differences could be due to different diagnostic methods and timing of evaluation. Risk factors include first born status, female sex, positive family history, breech presentation and oligohydramnios. Clinical presentations of DDH depend on the age of the child. Newborns present with hip instability, infants have limited hip abduction on examination, and older children and adolescents present with limping, joint pain, and/or osteoarthritis. Repeated, careful examination of all infants from birth and throughout the first year of life until the child begins walking is important to prevent late cases. Provocative testing includes the Barlow and Ortolani maneuvers. Other signs, such as shorting of the femur with hips and knees flexed (Galeazzi sign), asymmetry of the thigh or gluteal folds, and discrepancy of leg lengths are potential clues. Treatment depends on age at presentation and outcomes are much better when the child is treated early, particularly during the first six months of life.

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