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  • Original Article
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Sonographic screening for developmental dysplasia of the hip in preterm breech infants: do current guidelines address the specific needs of premature infants?

Journal of Perinatology volume 36, pages 552–556 (2016)Cite this article

Subjects

Abstract

Objective:

To assess the association between gestational age versus corrected age at the time of hip ultrasound with findings for developmental dysplasia of the hip (DDH) in preterm breech infants.

Study Design:

A retrospective medical chart review was conducted to examine hip ultrasounds of 318 premature breech infants for findings associated with DDH.

Results:

Positive findings for DDH occurred in 3/135 (2%) of infants <32 weeks gestational age and 17/183 (9%) of infants 32 to <37 weeks gestational age (odds ratio: 0.22, 95% CI: 0.04 to 0.79, P<0.015). No infants born <32 weeks gestational age had abnormal findings for DDH upon follow-up ultrasound. Infants <40 weeks corrected age at the time of hip ultrasound were more likely to have DDH findings compared with infants ⩾44 weeks corrected age (odds ratio: 7.83, 95% CI: 2.20 to 29.65, P<0.001).

Conclusion:

Current hip ultrasonography policies that include screening of premature breech infants may need to be revised.

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References

  1. Storer SK, Skaggs DL . Developmental dysplasia of the hip. Am Fam Physician 2006; 74: 1310–1316.

    PubMed  Google Scholar 

  2. Chan A, McCaul KA, Cundy PJ, Haan EA, Byron-Scott R . Perinatal risk factors for developmental dysplasia of the hip. Arch Dis Child 1997; 76: F94–F100.

    Article  CAS  Google Scholar 

  3. Goldberg MJ . Early detection of developmental hip dysplasia: synopsis of the AAP Clinical Practice Guideline. Pediatr Rev 2001; 22: 131–134.

    Article  CAS  Google Scholar 

  4. Atweh LA, Kan JH . Multimodality imaging of developmental dysplasia of the hip. Pediatr Radiol 2013; 43: 166–171.

    Article  Google Scholar 

  5. Rosendahl K, Markestad T, Lie RT . Developmental dysplasia of the hip. A population-based comparison of ultrasound and clinical findings. Acta Paediatr 1996; 85: 64–69.

    Article  CAS  Google Scholar 

  6. Chan A, Foster BK, Cundy PJ . Problems in the diagnosis of neonatal hip instability. Acta Paediatr 2001; 90: 836–839.

    Article  CAS  Google Scholar 

  7. American Institute of Ultrasound in Medicine. AIUM practice guideline for the performance of an ultrasound examination for detection and assessment of developmental dysplasia of the hip. J Ultrasound Med 2013; 32: 1307–1317.

    Article  Google Scholar 

  8. American Academy of Pediatrics. Clinical practice guideline: early detection of developmental dysplasia of the hip. Committee on Quality Improvement, Subcommittee on Developmental Dysplasia of the Hip. Pediatrics 2000; 105: 896–905.

    Article  Google Scholar 

  9. Hickok DE, Gordon DC, Milberg JA, Williams MA, Daling JR . The frequency of breech presentation by gestational age at birth: a large population-based study. Am J Obstet Gynecol 1992; 166: 851–852.

    Article  CAS  Google Scholar 

  10. Weggemann T, Brown JK, Fulford GE, Minns RA . A study of normal baby movements. Child Care Health Dev 1987; 13: 41–58.

    Article  CAS  Google Scholar 

  11. Kosar P, Ergun E, Gokharman FD, Turgut AT, Kosar U . Follow-up sonographic results for graf type 2a hips. J Ultrasound Med 2011; 30: 677–683.

    Article  Google Scholar 

  12. Roovers EA, Boere-Boonekamp MM, Castelein RM, Zielhuis GA, Kerkhoff TH . Effectiveness of ultrasound screening for developmental dysplasia of the hip. Arch Dis Child Fetal Neonatal Ed 2005; 90: F25–F30.

    Article  CAS  Google Scholar 

  13. Quan T, Kent AL, Carlisle H . Breech preterm infants are at risk of developmental dysplasia of the hip. J Paediatr Child Health 2013; 49: 658–663.

    Article  Google Scholar 

  14. Rosendahl K, Dezateux C, Fosse KR, Aase H, Aukland SM, Reigstad H et al. Immediate treatment versus sonographic surveillance for mild hip dysplasia in newborns. Pediatrics 2010; 125: e9–e16.

    Article  Google Scholar 

  15. Karmazyn BK, Gunderman RB, Coley BD, Blatt ER, Bulas D, Fordham L et al. American College of Radiology. ACR Appropriateness Criteria on developmental dysplasia of the hip—child. J Am Coll Radiol 2009; 6: 551–557.

    Article  Google Scholar 

  16. Sewell MD, Eastwood DM . Screening and treatment in developmental dysplasia of the hip—where do we go from here? Int Orthop 2011; 35: 1359–1367.

    Article  Google Scholar 

  17. Shipman SA, Helfand M, Moyer VA, Yawn BP . Screening for developmental dysplasia of the hip: a systematic literature review for the US Preventive Services Task Force. Pediatrics 2006; 117: e557–e576.

    Article  Google Scholar 

  18. Bialik V, Bialik GM, Blazer S, Sujov P, Wiener F, Berant M . Developmental dysplasia of the hip: a new approach to incidence. Pediatrics 1999; 103: 93–99.

    Article  CAS  Google Scholar 

  19. Woolacott NF, Puhan MA, Steurer J, Kleijnen J . Ultrasonography in screening for developmental dysplasia of the hip in newborns: systemic review. BMJ 2005; 330: 1413.

    Article  Google Scholar 

  20. Mahan ST, Katz JN, Kim YJ . To screen or not to screen? A decision analysis of the utility of screening for developmental dysplasia of the hip. J Bone Joint Surg Am 2009; 91: 1705–1719.

    Article  Google Scholar 

  21. US Preventive Services Task Force. Screening for developmental dysplasia of the hip: recommendation statement. Pediatrics 2006; 117: 898–902.

    Article  Google Scholar 

  22. Barr LV, Rehm A . Should all twins and multiple births undergo ultrasound examination for developmental dysplasia of the hip? A retrospective study of 990 multiple births. Bone Joint J 2013; 95: 132–134.

    Article  Google Scholar 

  23. Dezateux C, Rosendahl K . Developmental dysplasia of the hip. Lancet 2007; 369: 1541–1552.

    Article  Google Scholar 

  24. Omeroglu H . Use of ultrasonography in developmental dysplasia of the hip. J Child Orthop 2014; 8: 105–113.

    Article  Google Scholar 

  25. Jones DA . Neonatal detection of developmental dysplasia of the hip. J Bone Joint Surg 1998; 80-B: 943–945.

    Article  Google Scholar 

  26. Chiara A, De Pellegrin M . Developmental dysplasia of the hip: to screen or not to screen with ultrasound. Early Hum Dev 2013; 89: S102–S103.

    Article  Google Scholar 

  27. Keller MS, Nijs ELF . The role of radiographs and US in developmental dysplasia of the hip: how good are they? Pediatr Radiol 2009; 39: S211–S215.

    Article  Google Scholar 

  28. Nemeth BA, Narotam V . Developmental dysplasia of the hip. Pediatr Rev 2012; 33: 533–561.

    Article  Google Scholar 

  29. Elbourne D, Dezateux C, Arthur R, Clarke NMP, Gray A, King A et al. Ultrasonography in the diagnosis and management of developmental hip dysplasia (UK Hip Trial): clinical and economic results of a multicenter randomised controlled trial. Lancet 2002; 360: 2009–2017.

    Article  Google Scholar 

  30. Gray A, Elbourne D, Dezateux C, King A, Quinn A, Gardner F . Economic evaluation of ultrasonography in the diagnosis and management of developmental hip dysplasia in the United Kingdom and Ireland. J Bone Joint Surg Am 2005; 87: 2472–2479.

    PubMed  Google Scholar 

  31. Roposch A, Liu LQ, Protopapa E . Variations in the use of diagnostic criteria for developmental dysplasia of the hip. Clin Orthop Relat Res 2013; 471: 1946–1954.

    Article  Google Scholar 

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Acknowledgements

The authors thank Dureya Syed and Tabinda Syed for their assistance with this research. The authors received no financial support for the research, authorship and/or publication of this article.

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Authors and Affiliations

  1. Cohen Children's Medical Center of New York, Lake Success, NY, USA

    J Lee, R M Spinazzola, M Perrin & R L Milanaik

  2. The Feinstein Institute for Medical Research, Manhasset, NY, USA

    N Kohn

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  1. J Lee
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  2. R M Spinazzola
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  3. N Kohn
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  4. M Perrin
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  5. R L Milanaik
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Correspondence to R L Milanaik.

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Lee, J., Spinazzola, R., Kohn, N. et al. Sonographic screening for developmental dysplasia of the hip in preterm breech infants: do current guidelines address the specific needs of premature infants?. J Perinatol 36, 552–556 (2016). https://doi.org/10.1038/jp.2016.7

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