Keywords
Ultrasonography
Risk Factors
Diagnostic Screening Programs
Health Resources
How to Cite
Abstract
Introduction and Objectives
Developmental dysplasia of the hip (DDH) is associated with various recognised risk factors. Diagnosis is primarily made using hip ultrasonography from the first month of life. However, a large number of ultrasounds are requested solely on the basis of risk factors, contributing to considerable healthcare expenditure. This study aims to determine which risk factors are truly associated with DDH in order to enable more efficient use of healthcare resources.
Patients and Methods
A retrospective observational study was conducted, analysing the medical records of 206 infants who underwent hip ultrasound to rule out DDH due to the presence of risk factors.
Results
Ninety-one percent of the infants diagnosed with DDH were female. Only a positive Ortolani sign [OR 42.37; 95% CI (5.31–482.87); p=0.001] and Barlow sign [OR 17.41; 95% CI (1.01–534.70); p=0.057] were significantly associated with an increased risk of DDH. Over one-third of the ultrasounds were requested due to hip clicks or asymmetrical skin folds and were normal in more than 90% of cases. A strict selective screening approach could yield annual savings of approximately €40,000.
Conclusions
Ultrasound screening guided by clinical examination remains the method of choice for ruling out DDH. Positive Barlow and Ortolani tests significantly increase the likelihood of diagnosis. In contrast, asymmetrical skin folds, hip clicks, and breech presentation do not appear to be associated with a higher risk.
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