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Developmental hip dysplasia, the most common congenital defect in newborns, can lead to early arthritis of the hip if not corrected. But clinicians have disagreed over the most effective way to diagnose the condition. Now, a study by Susan Mahan, MD, MPH, of Children’s Department of Orthopedic Surgery, suggests that selective screening might be the most effective diagnostic path to take. Mahan and colleagues analyzed data from more than 70 studies and clinical trials dating back to 1939 to compare the long-term outcomes of three approaches: physical exam and ultrasound screening for all newborns, physical exam for all newborns with selective ultrasound screening (for infants with a positive physical exam, positive family history or risk factors such as breech delivery); or no screening. In their decision analysis, published in the July issue of The Journal of Bone and Joint Surgery, the highest probability of having a non-arthritic hip by age 60 came with the selective screening strategy.
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