Musculoskeletal Screening: Developmental Dysplasia of the Hip

Abstract

Developmental dysplasia of the hip (DDH) is common because it is present in 1 of 100 newborns. Failure to diagnose DDH and treat in infancy can result in significant long-term disability. Early diagnosis can be accomplished through a quick but careful physical examination of all newborns. Further selective screening by ultrasound is indicated for those children with risk factors for DDH, which include family history, breech presentation, and unstable hip examination at the initial newborn examination. Continued examination of the hip at all routine well-child checkups is mandatory through the first year of life because late presenting DDH may occur. Treatment with a Pavlik harness is not typically instituted in the neonate because many unstable hips stabilize without intervention, but it is indicated in children older than 2 weeks with hip instability. Ultrasound screening for infants with risk factors for DDH is recommended at age 6 weeks. Pavlik harness treatment for children with unstable hips or significant dysplasia on ultrasound is continued until the hips stabilize and show concentric reduction on imaging. With time, diagnosis and treatment evolve to accommodate the growing child. Infants who fail to respond to nonoperative management may require more extensive interventions. At any time when treatment is initiated, a DDH specialist should be involved in the patient's care. If DDH is recognized early, treatment is less invasive, and long-term effects are minimized.

Chiropractic Management of Low Back Pain in a 75-Year-Old Man With Bilateral Developmental Hip Dysplasia

“…In developed countries, DDH is encountered in 1 per 100 newborns, making it a commonly diagnosed and treated neonatal condition. 2 This is in contrast to developing countries where untreated cases are common. 3 Developmental dysplasia of the hip was commonly diagnosed by plain radiography or computed tomographic scans in those older than 6 months.…”

Patient-Specific Templates for Triple Pelvic Osteotomy in Children with Dysplastic Hip Subluxation (Preliminary Results)

“…Дисплазия тазобедренных суставов остается одним из наиболее встречающихся заболеваний костно-мышечной системы у детей. Согласно данным, представленным различными авторами, частота этой патологии в разных странах варьирует от 2 до 50 и более случаев на 1000 новорожденных [1][2][3][4][5]. несмотря на постоянно совершенствующиеся методы диагностики ортопедических заболеваний, процент несвоевременного выявления дисплазии тазобедренных суставов остается довольно высоким [6].…”

The predictive value of the clinical sign of excessive hip abduction for developmental dysplasia of the hip (DDH)

“…The criteria for Čustović at al defining cases of developmental dysplasia of the hip diagnosed later in life are uneven. If DDH is recognized early, treatment is less invasive, and long-term effects are minimized (7,14).…”