Neonatal screening and selective sonographic imaging in the diagnosis of developmental dysplasia of the hip
| Autor: | R W Paton, Qas A. Choudry |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
Pediatrics
medicine.medical_specialty Observational assessment Sensitivity and Specificity Screening programme Cohort Studies 03 medical and health sciences 0302 clinical medicine Neonatal Screening Predictive Value of Tests 030225 pediatrics medicine Humans Orthopedics and Sports Medicine 030212 general & internal medicine Longitudinal Studies Prospective Studies Prospective cohort study Hip Dislocation Congenital Ultrasonography Clinical screening business.industry Developmental dysplasia Infant Newborn Infant A300 Predictive value Surgery Hip Joint business |
| Zdroj: | The bonejoint journal. (6) |
| ISSN: | 2049-4408 2049-4394 |
| Popis: | Aims The aim of this prospective cohort study was to evaluate the effectiveness of the neonatal hip instability screening programme. Patients and Methods The study involved a four-year observational assessment of a neonatal hip screening programme. All newborns were examined using the Barlow or Ortolani manoeuvre within 72 hours of birth; those with positive findings were referred to a ‘one-stop’ screening clinic for clinical and sonographic assessment of the hip. The results were compared with previous published studies from this unit. Results A total of 124 newborns with a positive Barlow or Ortolani manoeuvre, clunk positive, or ‘unstable’ were referred. Five were found to have clinical instability of the hip. Sonographically, 92 newborns had Graf Type I hips, 12 had Graf Type II hips, and 20 had Graf Type IV hips. The positive predictive value (PPV) of clinical screening was 4.0% and the PPV of sonography was 16.1%. This has led to an increased rate of surgery for DDH. Conclusion Compared with previously published ten-year and 15-year studies, there has been a marked deterioration in the PPV in those referred with potential instability of the hip. There appears to be a paradox, with rising referrals and a decreasing PPV combined with an increasing rate of surgery in newborns with developmental dysplasia of the hip. Cite this article: Bone Joint J 2018;100-B:806–10. |
| Databáze: | OpenAIRE |
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