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

Tan, Si Heng Sharon; Wong, Keng Lin; Lim, Andrew Kean Seng; Hui, James Hoipo

Abstract

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).