Positive predictive values in clinical screening for developmental dysplasia of the hip

Husum, Hans-Christen; Ghaffari, Arash; Rytoft, Laura Amalie; Svendsson, Jens Egebjærg Rye; Harving, Søren; Kold, Søren; Rahbek, Ole

doi:10.1111/apa.15896

Cited by 6 publications

(17 citation statements)

References 11 publications

(17 reference statements)

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“…The referral rate of 0.9% for the Ortolani and Barlow tests was acceptable. The rate was comparable to the rate of neonatal hip instability (0.86%) in infants clinically screened by senior paediatric staff in the prospective study by Holen et al 25 Others have described higher rates of positive Ortolani and Barlow tests even above 2% with different health professionals, 5,17 but also a rate of 0.4% has been presented 6 …”

Section: Discussionsupporting

confidence: 65%

“…The Ortolani 1 and Barlow tests 2 are accepted as the cornerstone of DDH clinical screening, 3,4 even if there is no adequate evidence of their accuracy. The positive predictive value (PPV) of clinical hip examination could be as low as 5%, 5 and referral rates are increasing 6,7 . Previous studies have not described the differences between the Ortolani and Barlow tests in terms of their PPV.…”

Section: Introductionmentioning

confidence: 99%

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The Ortolani test has a high positive predictive value in clinical hip screening for developmental dysplasia of the hip

2023

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Many controversies surround screening for developmental dysplasia of the hip (DDH). The Ortolani 1 and Barlow tests 2 are accepted as the cornerstone of DDH clinical screening, 3,4 even if there is no adequate evidence of their accuracy. The positive predictive value (PPV) of clinical hip examination could be as low as 5%, 5 and referral rates are increasing. 6,7 Previous studies have not described the differences between the Ortolani and Barlow tests in terms of their PPV. However, it is widely accepted that the Ortolani test is the most important test as it indicates when the femoral head is dislocated at rest. 3,8,9 The spontaneous resolution of clinical instability makes the diagnosis of pathological hip dysplasia difficult. Delaying the hip

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Section: Discussionsupporting

confidence: 65%

Section: Introductionmentioning

confidence: 99%

The Ortolani test has a high positive predictive value in clinical hip screening for developmental dysplasia of the hip

2023

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“…El diagnóstico de displasia de desarrollo de cadera (DDC) en recién nacidos es importante, por ello, determinar los métodos diagnósticos es fundamental para poder brindar un tratamiento adecuado a los pacientes, es así que Husum et al (3) , indican que los métodos diagnósticos para la DDC son el cribado clínico o la ultrasonografía selectiva.…”

Section: Discussionunclassified

“…Varios autores mencionan que el método diagnóstico más utilizado es la ultrasonografía selectiva, (3,4,5,9,11,12,13,15,16,18,19,2,21) lo cual se complementa con lo que menciona la Academia Estadounidense de Pediatría (AAP) quien recomienda un examen clínico para DDC al nacer seguido de una ultrasonografía (USF) a las 6 semanas en todos los recién nacidos en riesgo.…”

Section: Discussionunclassified

“…(2) Pese a la larga historia de esta patología, hasta la fecha no se logra definir una etiopatogenia exacta, puesto que es multifactorial y se asocia a factores de riesgos conocidos. (3,4,5) Estos son genéticos, ambientales y mecánicos, por ello, su diagnóstico precoz hace un gran hincapié para abordar adecuadamente al paciente pediátrico y de esta manera prevenir anomalías. (6) La DDC, es frecuente y afecta del 1 % al 3 % de todos los bebés, y a pesar de esto sigue faltando evidencia de calidad que sirva de guía para la práctica clínica a los profesionales de la salud, e inclusive la etiología de la afección aún no está del todo clara, a lo largo de los años se han publicado numerosos artículos a nivel mundial pero siempre se han venido presentado varias controversias sobre cuál es el método diagnóstico ideal e inclusive el tratamiento adecuado conforme a cada paciente, esta patología es uno de los trastornos congénitos más comunes de la infancia y así como tiene diversos cambios patológicos requiere de diferentes tratamientos que incluso dan diferentes resultados.…”

Section: Introductionunclassified

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Diagnosis of hip dysplasia in newborns

Hidalgo

González

Idrovo

et al. 2022

Salud, Ciencia y Tecnología

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Antecedentes: La displasia del desarrollo de cadera es una patología muy frecuente en los recién nacidos siendo el trastorno de cadera más común en ortopedia pediátrica. Objetivo: Describir los métodos diagnósticos de displasia del desarrollo de cadera en recién nacidosMetodología: Se realizó una revisión bibliográfica, y se recolectó artículos indexados de bases de datos: PubMed, Scopus y Web of Science, la búsqueda no tuvo límite de tiempo. Resultados: En el diagnóstico de displasia de desarrollo de cadera (DDC) en recién nacidos, determinar los métodos diagnósticos es fundamental para poder brindar un tratamiento adecuado a los pacientes; los métodos diagnósticos para la DDC son el cribado clínico o la ultrasonografía selectiva. Además se debe incluir una historia clínica completa, incluyendo factores de riesgo y un examen físico con las maniobras de Barlow y Ortolani acompañado de la ultrasonografía. El método diagnóstico más utilizado es la ultrasonografía selectiva. El examen clínico ayuda a la detección temprana y una derivación para el manejo de esta, con la finalidad de evitar morbilidades a largo plazo que comprometen el estilo de vida de los pacientes.Conclusiones: Los métodos diagnósticos para la displasia del desarrollo de cadera más utilizados en varios países son el cribado clínico y la ultrasonografía selectiva, en donde, el primero se basa en una evaluación completa del recién nacido basado en la historia clínica, evaluando los antecedentes y factores de riesgo de DDC, acompañado de maniobras como lo son Ortalani y Barlow.

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Prevalence of Acetabular Dysplasia at a Mean age of 18 Years After Treatment for Neonatal hip Instability

Maikku,

Valkama,

Ohtonen

et al. 2024

Journal of Pediatric Orthopaedics

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Background: The long-term radiological outcomes after the treatment of neonatal hip instability (NHI) in developmental dysplasia of the hip are unclear. Therefore, the prevalence of acetabular dysplasia at a mean age of 18 years after treatment was investigated. The relationship between acetabular dysplasia and hip discomfort has also been poorly established. Therefore, the differences in pain, hip-related quality of life (QOL), and hip impingement tests in hips with and without acetabular dysplasia were assessed. Methods: All 127 patients treated for NHI from 1995 to 2001 at the study hospital and meeting the inclusion criteria were invited to participate in this population-based follow-up. Of these individuals, 88 (69.3%) participated. The lateral center-edge angle (LCEA), Sharp’s angle (SA), and acetabular head index (AHI) were calculated for both hips from pelvic anterior–posterior radiographs. The Copenhagen Hip and Groin Outcome Score (HAGOS) questionnaire was completed for both hips separately; the total score, pain, and QOL subscores were calculated; and the impingement test was performed. Results: The prevalence of acetabular dysplasia, defined as an LCEA <20°, was 3.4%. Only the mean AHI (81.1%, SD 5.3) differed (-5.08, 95% CI -5.77 to -4.38, P <0.001) from previously described gender-specific and side-specific means, whereas the mean LCEA and SA did not. The odds ratio for a positive hip impingement test was 2.8 (95% CI: 1.11-7.05, P = 0.029) for hips with an LCEA <25° compared to hips with LCEA ≥25°. The hips with an SA ≥45° had a mean of 7.8 points lower for the HAGOS pain subscore (95% CI: 4.2-11.4, P <0.001) and a mean of 6.1 points lower for the HAGOS QOL subscore (95% CI: 2.1-10.2, P = 0.003) compared with hips with an SA <45°. Conclusions: The prevalence of acetabular dysplasia was low after treatment for NHI. Acetabular dysplasia seems to be as common in the general population as for those treated for NHI based on the LCEA. Only an SA ≥45° resulted in slightly more pain and lower hip-related QOL.

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Positive predictive values in clinical screening for developmental dysplasia of the hip

Cited by 6 publications

References 11 publications

The Ortolani test has a high positive predictive value in clinical hip screening for developmental dysplasia of the hip

The Ortolani test has a high positive predictive value in clinical hip screening for developmental dysplasia of the hip

Diagnosis of hip dysplasia in newborns

Prevalence of Acetabular Dysplasia at a Mean age of 18 Years After Treatment for Neonatal hip Instability

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