Screening of Developmental Dysplasia of the Hip in Europe: A Systematic Review

Krysta, Wojciech; Dudek, Patryk; Pulik, Łukasz; Łęgosz, Paweł

doi:10.3390/children11010097

Cited by 3 publications

References 49 publications

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ECAD Study: Evaluating agreement degree among paediatricians in hip dysplasia assessment by Graf ultrasound method

Aguilar,

Marrón,

Gómez

et al. 2024

Preprint

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Introduction: developmental dysplasia of the hip (DDH) is the most common musculoskeletal anomaly of childhood. This study analyses paediatrician’s concordance performing hip ultrasound according to Graf's method. Materials and methods an analytical cross-sectional study is designed. Patients’ hips are evaluated by Graf´s ultrasound method at 4–6 and 12–16 weeks of age. Demographic characteristics, pregnancy history, factors related to DDH, hip type, and α and β angles are collected. To assess agreement degree of hip diagnosis and hip types Kappa index (I. kappa) is used. Intraclass correlation coefficient (ICC) evaluates concordance of α and β angles. A p value < 0.05 is considered to be statistically significant. All results are represented with their 95% confidence interval (95% CI). Results 467 neonates are recruited and meet inclusion criteria. 3182 images were analysed. Agreement between paediatricians according to hip diagnosis and different types ranges from moderate to almost perfect I. kappa 0.6–1.0 (95%CI 0.5–0.7; 95%CI 1.0–1.0). α angle ICC for paediatricians is between 0.75–0.88 (95%CI 0.61–0.86; 95%CI 0.80–0.92). β angle value agreement degree among paediatricians at both visits is moderate. Discussion Graf method is the most popular ultrasound technique for hip assessment. In our setting, paediatricians carry out children follow-up, therefore, they should perform universal screening. In this study agreement degree between paediatricians varies between substantial and almost perfect. As conclusion, Graf ultrasound procedure performed by paediatricians is a reliable test and can be used for DDH screening.

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ECAD Study: Evaluating agreement degree among paediatricians in hip dysplasia assessment by Graf ultrasound method

Aguilar,

Marrón,

Gómez

et al. 2024

Preprint

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The Etiology of Neuromuscular Hip Dysplasia and Implications for Management: A Narrative Review

Presedo,

Rutz,

Howard

et al. 2024

Children

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This study summarizes the current knowledge of the etiology of hip dysplasia in children with neuromuscular disease and the implications for management. This article is based on a review of development of the hip joint from embryology through childhood growth. This knowledge is then applied to selective case reviews to show how the understanding of these developmental principles can be used to plan specific treatments. The development of the hip joint is controlled by genetic shape determination, but the final adult shape is heavily dependent on the mechanical environment experienced by the hip joint during growth and development. Children with neuromuscular conditions show a high incidence of coxa valga, hip dysplasia, and subluxation. The etiology of hip pathology is influenced by factors including functional status, muscular tone, motor control, child’s age, and muscle strength. These factors in combination influence the development of high neck–shaft angle and acetabular dysplasia in many children. The hip joint reaction force (HJRF) direction and magnitude determine the location of the femoral head in the acetabulum, the acetabular development, and the shape of the femoral neck. The full range of motion is required to develop a round femoral head. Persistent abnormal direction and/or magnitude of HJRF related to the muscular tone can lead to a deformed femoral head and a dysplastic acetabulum. Predominating thigh position is the primary cause defining the direction of the HJRF, leading to subluxation in nonambulatory children. The magnitude and direction of the HJRF determine the acetabular shape. The age of the child when these pathomechanics occur acts as a factor increasing the risk of hip subluxation. Understanding the risk factors leading to hip pathology can help to define principles for the management of neurologic hip impairment. The type of neurologic impairment as defined by functional severity assessed by Gross Motor Function Classification System and muscle tone can help to predict the risk of hip joint deformity. A good understanding of the biomechanical mechanisms can be valuable for treatment planning.

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Screening Accuracy for Developmental Dysplasia of the Hip by Child Health Nurses

Smart,

Cundy,

Williams

et al. 2024

Children

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Background: Developmental Dysplasia of the Hip (DDH) describes a spectrum of abnormalities that impact the normal function of the joint. These abnormalities are detectable during infancy using physical assessment, universal ultrasound, or a combination of both. In Australia, child health nurses predominantly screen for this disease using physical assessment. The aim of this study was to determine if child health nurses can accurately screen for DDH using physical assessment. Methods: This Australian study estimated the accuracy and utility of child health nurses using physical assessment to screen for DDH by comparing it to a handheld ultrasound device. Results: This study (N = 44) concluded that using a point prevalence study design, child health nurses in Australia are unable to accurately assess for DDH in infants using physical assessment; overall, clinicians had 50.5% sensitivity (95% CI, 15.7 to 84.3), a specificity of 75.0% (95% CI, 57.8 to 87.9), and 71.3% accuracy (95% CI, 55.6 to 83.9). Conclusion: This study suggests that child health nurses cannot screen for DDH using physical assessment. Understanding education, experience and what assessments are used suggests that the utility of nurses performing DDH screening requires further investigation.

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Screening of Developmental Dysplasia of the Hip in Europe: A Systematic Review

Cited by 3 publications

References 49 publications

ECAD Study: Evaluating agreement degree among paediatricians in hip dysplasia assessment by Graf ultrasound method

ECAD Study: Evaluating agreement degree among paediatricians in hip dysplasia assessment by Graf ultrasound method

The Etiology of Neuromuscular Hip Dysplasia and Implications for Management: A Narrative Review

Screening Accuracy for Developmental Dysplasia of the Hip by Child Health Nurses

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