The Role of Ultrasonography in the Diagnosis of Developmental Dysplasia of the Hip

Portinaro, Nicola; Pelillo, Francesco; Cerutti, Paola

doi:10.1097/bpo.0b013e3180317422

Cited by 28 publications

(13 citation statements)

References 37 publications

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“…14,15 A recent Cochrane review found that neither of the ultrasound strategies have been demonstrated to improve clinical outcomes including late diagnosed DDH and surgery. 16 Further conflicting information regarding the optimal screening procedure for DDH has arisen after the United States Preventive Services Task Force found insufficient evidence to recommend routine DDH screening, including physical examination.…”

Section: Discussionmentioning

confidence: 99%

Patient factors associated with delayed diagnosis of developmental dysplasia of the hip

Lindberg

Bompadre

Satchell

et al. 2017

Journal of Children's Orthopaedics

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PurposeEarly detection and intervention for developmental dysplasia of the hip (DDH) is important for normal hip development. Previous studies have shown disparities in access to paediatric specialty care among different racial and socioeconomic backgrounds. This study aims to identify whether these factors are related to timely referral for infants with DDH.MethodsA retrospective cohort study of patients seen and treated for DDH between July 2006 and June 2011 at a single institution were reviewed. The patients were divided into early-presenting (seen before six months of age) and late-presenting patients (seen at six months of age or later).ResultsA total of 457 patients met the eligibility criteria. There were 378 early and 79 late presentations. Late presentations were significantly more likely to be vertex at birth (85% vs 41%, p < 0.001). Bivariate analysis also demonstrated that late presentations were more likely to be non-white (65% vs 45%, p = 0.004), non-English speaking (20% vs 8%, p = 0.003), from lower income areas ($70 769 vs $61 591, p < 0.001) and hold public insurance (25%, p = 0.001). However, a logistic multiple regression analysis showed that only vertex birth presentation (p = 0.000), absent family history of DDH (p = 0.047) and affected right side (p = 0.001) were significantly associated with late presentation.ConclusionDespite screening algorithms to facilitate early diagnosis of infants with DDH, better research is needed to understand how different demographic and socioeconomic factors play into the delayed access to paediatric orthopaedic care for DDH so that we may ultimately improve rates of early treatment.

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Section: Discussionmentioning

confidence: 99%

Patient factors associated with delayed diagnosis of developmental dysplasia of the hip

Lindberg

Bompadre

Satchell

et al. 2017

Journal of Children's Orthopaedics

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“… 21 22 In such studies, the reliability of Graf hip ultrasonography was reportedly poor to good. 10 11 12 13 Although various authors have reported that the performance of ultrasonography may vary depending on the individual, 23 24 25 very few studies have examined the reliability in this regard. Bar-On et al .…”

Section: Discussionmentioning

confidence: 99%

The reliability of ultrasonography in developmental dysplasia of the hip

Orak

Onay

Cagirmaz³

et al. 2015

IJOO

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Background:Developmental dysplasia of the hip (DDH) is the most common skeletal dysplasia. Two principal methods used in early diagnosis of DDH are clinical examination and ultrasonographic investigation. Dogruel et al. found a low specificity of clinical examination in patients with DDH. Additionally, Kamath et al. stated that ultrasonography performed by a radiologist in routine clinical practice is more reliable than physical examination performed by the average clinician. In clinical practice, the application and assessment of hip ultrasonography are completed by a single person. This assessment determines the followup of the patient. Thus, hip ultrasonography performed on the same person by different individuals under the same conditions will yield a more accurate assessment of the reliability of ultrasonographic assessment of DDH. Although inter-observer reliability was high in many previous studies of ultrasound image evaluation, reliability rates vary among studies of the application of ultrasonography.Materials and Methods:Inter-examiner reliability of hip ultrasonography was analyzed among four investigators who separately evaluated 100 hips (50 infants). The obtained bone structure angles α, cartilage structure angles β, and distribution of hip types were compared among the investigators. All infants were brought to the hospital for a healthy child followup examination, according to the country's health policy. Babies between 0 and 6 months were included in the study. Babies with any neuromuscular disorders, neural tube defects or any type of genetic anomalies were excluded from the study. The study was explained to the families of all infants and written informed consent was obtained.Results:There was a significant difference in the hip type determined by the investigators with respect to α and β angles (P < 0.01, P < 0.01, P = 0.002). The average alpha measurements of the first orthopedist, second orthopedist, first radiologist, and second radiologist were 67.38 ± 6.24, 65.60 ± 5.84, 65.44 ± 4.59, and 62.59 ± 4.50, respectively. The average beta measurements of the first orthopedist, second orthopedist, first radiologist, and second radiologist were 53.85 ± 8.86, 50.74 ± 7.80, 44.77 ± 6.30, and 44.39 ± 5.81, respectively. Agreement among the results obtained by the clinicians was investigated in dual comparisons. The relative agreement according to the alpha angle ranged from 3.6% to 44.5%, and the relative concordance according to the beta angle ranged from 0.9% to 45.3%. Agreement regarding hip typing was determined to range from 19.1% to 42.6%.Conclusion:Sonographic evaluation of the hip appears to vary depending on the investigator.

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“…Doğum öncesi ve sonrası mekanik faktörler, anne hormonları kaynaklı bağ gevşekliği, asetabuler displazi, ırk özellikleri, gelişimsel faktörler, yaşam biçimi özellikleri (kundaklama), genetik ve çevresel etkenler gibi risk faktörleri bunlar arasında sayılabilir (22,23). Diğer tanımlanmış risk faktörleri postüral ve yapısal ayak deformiteleri (metatarsus adduktus, pes kalkaneovalgus, pes ekinovarus), tortikolis, yüksek doğum tartısı, eklem laksitesi, oligohidroamnioz, ilk bebek olması ve zor doğum öyküsüdür (24,25). Çalışmamızda GKD ile kız cinsiyet, sağ kalça tutulumu, aile öyküsü varlığı, kundaklama ve metatarsus adduktus arasında anlamlı ilişki bulunmuştur.…”

Section: Discussionunclassified

Hip Ultrasonography in the Diagnosis of Developmental Dysplasia of the Hip: Bakırköy Experience

Duramaz¹,

Peker²,

Arslan³

et al. 2014

Haseki

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The Role of Ultrasonography in the Diagnosis of Developmental Dysplasia of the Hip

Cited by 28 publications

References 37 publications

Patient factors associated with delayed diagnosis of developmental dysplasia of the hip

Patient factors associated with delayed diagnosis of developmental dysplasia of the hip

The reliability of ultrasonography in developmental dysplasia of the hip

Hip Ultrasonography in the Diagnosis of Developmental Dysplasia of the Hip: Bakırköy Experience

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