The earliest timing ultrasound can be performed in the screening for developmental dysplasia of the hips (DDH)
Si Heng Sharon Tan, Keng Lin Wong, Andrew Kean Seng Lim, James Hoipo Hui
National University Health Systems, Singapore, Singapore
Corresponding Author: Si Heng Sharon Tan ,Tel: 67795555, Fax: 67795555, Email: sharontansiheng@gmail.com
Received: December 7, 2018;  Accepted: March 3, 2019.  Published online: March 3, 2019.
ABSTRACT
Purpose:
The current study aims to evaluate the results of ultrasound screening done at various weeks of life, to determine the earliest timing ultrasound screening can be performed reliably.
Methods:
In the 17-year cohort study, all neonates who underwent ultrasound screening prior to the twelfth week of life with subsequent follow-up radiograph done at one year of life were included. The ultrasound images were evaluated according to Graf classification, Harcke's dynamic ultrasound screening and Terjesen's femoral head coverage. The radiographic images were evaluated according to acetabular index and femoral head position. The accuracy and correlation between the ultrasound findings performed at the various weeks of life with the radiographic findings performed at one year of life were evaluated.
Results:
A total of 348 neonates were included. When the ultrasound findings were correlated with the radiographic findings at one year of life, significant differences were identified for ultrasound screening performed prior to the fourth week of life (day 21 and before) (p < 0.05). In contrast, there were no significant differences identified when the ultrasound was performed between the fourth and twelfth week of life (day 22 and beyond) (p > 0.05). The accuracy of ultrasound screening was 79.2% and above when performed during or after the fourth week of life (day 22 and beyond).
Conclusion:
The earliest timing that ultrasound screening for DDH can be performed reliably is during the fourth week of life (day 22 and beyond).
Keywords: Hip dysplasia; Screening; Ultrasound; Radiograph; Imaging
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