Ultrasound screening for developmental dysplasia of the hip after 4 weeks increases exam accuracy and decreases follow-up visits

Lussier, Eric C.; Sun, Yiting; Chen, Hui-Wen; Chang, Tung-Yao; Chang, Chia‐Hsieh

doi:10.1016/j.pedneo.2018.07.008

Cited by 19 publications

(28 citation statements)

References 21 publications

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“…Hip ultrasonography for DDH diagnosis was first introduced in the 1980s by Graf. The Graf USG classification of hip development has improved early detection and accuracy for DDH (4). In 1992, Matos et al (5) stated that ultrasound of the infantile hip using the Graf USG method was an important tool for the assessment of developmental dysplasia of the hip and it could be used interpretation training and frequent use.…”

Section: Discussionmentioning

confidence: 99%

Interobserver reliability in the ultrasonic evaluation with graf method of developmental dysplasia of the hip: the importance of education for ultrasonography classification

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et al. 2020

Journal of Health Sciences and Medicine

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Birkaç ultrasonografi (USG) ölçümüyle gelişimsel kalça displazisi (GKD) deformitesi erken dönemde teşhis edilebilmektedir. Bu çalışmanın amacı, Graf USG yöntemini kullanarak gözlemciler arası güvenirliliği değerlendirmekti. Gereç ve Yöntem: Altmış iki rastgele ve ardışık olarak sağlanan hasta için Graf USG yöntemi ölçümlerde kullanıldı. Her hasta için her iki kalça US ölçümü yapıldı. Her US sonucu, multidisipliner yaklaşımla, ortopedik cerrahi uzmanı, çocuk hastalıkları uzmanı ve 25 yıl tecrübeli radyoloji uzmanıyla değerlendirildi. İstatistiksel ölçümler SPSS 20.0 (Windows, IL, ABD) ile yapıldı. Sınıf İçi Korelasyon Katsayısı belirlendi. % 95 Güven Aralığı ve Gerçek Değer 0 ile F Testi tespit edildi. 0,05'ten daha düşük p değerleri istatistiksel olarak anlamlı kabul edildi. Bulgular: Graf USG eğitiminden önceki değerlendirmede bulgular belirlendi. Gözlemciler arası güvenirlilikte, Sınıf içi sınıflama korelasyonları (ICC) değerleri, sağ kalçalar için Graf yöntemiyle değerlendirmede USG sınıflamasında 0,939 idi. ICC değerleri, sol kalçalar için Graf yöntemiyle değerlendirmede USG sınıflamasında 0,907 idi. Graf USG sınıflaması eğitiminden sonraki değerlendirmede, bulgular belirlendi. Graf yöntemiyle USG sınıflama değerlendirmesinde sağ kalçalar için ICC değerleri 0,975 idi. Graf yöntemiyle USG sınıflama değerlendirmesinde sol kalçalar için ICC değerleri 0,970 idi. Bütün p değerleri anlamlıydı. Graf USG yöntemi için eğitimden önce ICC değerleri sağ kalçalarda 0.838, sol kalçalarda 0.765 iken, eğitim sonrası sağ kalçalarda 0.928, sol kalçalarda 0.915 idi. Sonuç: USG ile GKD deformitesinin tanısı ciddi bir eğitim dönemi gerektiren karmaşık ve zor bir durumdur. Graf USG yöntemi yüksek gözlemciler arası güvenirliliğe sahip bulundu. Ayrıca Graf USG sınıflamasına yönelik eğitimin, özellikle çocuk doktorları arasında gözlemci içi güvenilirliği arttırdığını tespit ettik. Anahtar Kelimeler: Gelişimsel kalça displazisi, ultrasonografi, Graf, gözlemciler arası güvenirlilik, gözlemci içi güvenirlilik ABSTRACT Aim: Developmental dysplasia of the hip is a hip deformity that can be diagnosed early by numerous ultrasonography measurements. The purpose of this study was to evaluate the interobserver reliability of ultrasonography measurements using the Graf ultrasonography (USG) method. Material and Method: Ultrasonography measurements that were used by Graf ultrasonography (USG) method were obtained at presentation for 62 randomized and consecutive patients. Bilateral hip USG measurements were made for each patient. Each USG outcome was evaluated on multiple occasions by an orthopedic surgery specialist, a pediatric specialist, and a 25-year experienced radiologist. The statistical measurements were made by SPSS 20.0 (Windows, IL, USA). Intraclass Correlation Coefficient was determined. 95% Confidence Interval and F Test with True Value 0 was detected. P values were accepted as statistically significantly less than 0,05. Results: At the evaluation before education for Graf USG classification, the results were established. In the in...

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Section: Discussionmentioning

confidence: 99%

Interobserver reliability in the ultrasonic evaluation with graf method of developmental dysplasia of the hip: the importance of education for ultrasonography classification

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et al. 2020

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“…Ultrasound imaging allows the visualisation of the femoral head location relative to the acetabulum, and specific anatomic parameters, such as the depth of the acetabulum and inclination of the acetabular roof [11]. Ultrasound provides detailed visualisation of the cartilaginous anatomy of the hip that is not revealed by plain X-rays and allows early detection of DDH.…”

Section: Ultrasound Screening For Ddhmentioning

confidence: 99%

“…Gokharman et al [16] chose the fourth and eighth weeks of life as the timepoints for their study because of the observation from their clinical practice that most of ultrasound examinations performed during the first 4 -8 weeks of life. While, Lussier et al [11] chose the threshold of 28 days for their study because most screenings at their institutions were performed either in the first week of life or after 28 days of life. Both studies were then unable to give a precise time point for the earliest timing that ultrasound screening could be reliably performed, since their comparison groups included patients from a wide range of time points before versus after the fourth week or 28 days of life.…”

Section: Ultrasound Screening For Ddhmentioning

confidence: 99%

Developmental Dysplasia of the Hip: Management of Graf IIa Dysplastic Hip

Raba¹,

Gasibat²

2020

OJPed

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Developmental Dysplasia of the Hip (DDH) describes a wide range of anatomic abnormalities of the growing hips which might result in permanent abnormal gait. Therefore, early detection and management is crucial to improve the outcome and minimise the risk of osteoarthritis in later life. Hip ultrasound is used to evaluate DDH based on Graf classification. Graf score is a widely used ultrasound grading score to evaluate DDH in infants. There is conflicting evidence regarding the management of the developmentally immature Graf type IIa hip. Some physicians adopt watchful waiting for natural maturation of hips while other early treatment. This article will provide an evidence-based review on the management modalities of the Graf type IIa hip.

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“…However, the timing of ultrasound screening as part of the neonatal screening programme for DDH remains an ongoing topic of debate [6-9]. Ultrasound screenings that are performed too early can lead to a high incidence of false-positive or false-negative results, resulting in unnecessary anxiety, follow-up examinations, and financial burden [7,8]. In contrast, ultrasound screenings that are performed too late can result in delayed treatment, increasing the need for more invasive management, such as surgery, as well as imposing a financial burden [7,8].…”

Section: Introductionmentioning

confidence: 99%

“…Ultrasound screenings that are performed too early can lead to a high incidence of false-positive or false-negative results, resulting in unnecessary anxiety, follow-up examinations, and financial burden [7,8]. In contrast, ultrasound screenings that are performed too late can result in delayed treatment, increasing the need for more invasive management, such as surgery, as well as imposing a financial burden [7,8]. Despite the extensive literature available on ultrasound screening for DDH, no consensus exists regarding the ideal timing for ultrasound screening to be performed [8].…”

Section: Introductionmentioning

confidence: 99%

The earliest timing of ultrasound in screening for developmental dysplasia of the hips

et al. 2019

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Purpose: The current study aimed to evaluate the results of ultrasound screening for developmental dysplasia of the hips (DDH) done at various weeks of life, to determine the earliest time that ultrasound screening can be performed reliably. Methods: In this 17-year cohort study, all neonates who underwent ultrasound screening prior to the 12th week of life with subsequent follow-up radiography done at 1 year of life were included. The ultrasound images were evaluated according to the Graf classification, Harcke's dynamic ultrasound screening method, and Terjesen's femoral head coverage method. The radiographic images were evaluated according to the acetabular index and the femoral head position. The accuracy and correlation between the ultrasound findings from various weeks of life with the radiographic findings at 1 year of life were evaluated. Results: A total of 348 neonates were included in the study, of whom 92 had abnormal ultrasound findings and 42 had abnormal radiographic findings at 1 year. Significant differences were identified between the findings of ultrasound screening examinations performed prior to the fourth week of life (day 21 and before) and the radiographic findings at 1 year of life (P<0.05). In contrast, no significant differences were identified when ultrasound screening was performed between the fourth and 12th weeks of life (day 22 and beyond) (P>0.05). The accuracy of ultrasound screening was 79.2% or higher when performed during or after the fourth week of life (day 22 and beyond). Conclusion: The earliest that ultrasound screening for DDH can be performed reliably is during the fourth week of life (day 22 and beyond).

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Ultrasound screening for developmental dysplasia of the hip after 4 weeks increases exam accuracy and decreases follow-up visits

Cited by 19 publications

References 21 publications

Interobserver reliability in the ultrasonic evaluation with graf method of developmental dysplasia of the hip: the importance of education for ultrasonography classification

Interobserver reliability in the ultrasonic evaluation with graf method of developmental dysplasia of the hip: the importance of education for ultrasonography classification

Developmental Dysplasia of the Hip: Management of Graf IIa Dysplastic Hip

The earliest timing of ultrasound in screening for developmental dysplasia of the hips

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