Screening Experience for Hip Dysplasia at INR LGII from 2018 to January 2024

Abstract

INTRODUCTION: Developmental Dysplasia of the Hip (DDH) is an anatomical abnormality that significantly impacts the health and quality of life of children if not detected and treated properly. Despite advances in the treatment of DDH, it remains a major clinical challenge requiring accurate and timely diagnosis. In this context, early detection of DDH is crucial for initiating effective therapeutic interventions and preventing long-term complications such as pain or disability.

OBJECTIVE: To analyze the incidence of developmental dysplasia of the hip (DDH) diagnosed through screening and collect the demographic characteristics of the affected patients.

METHODOLOGY: Data collection was carried out for all patients seen from January 2018 to January 2024 at the hip dysplasia ultrasound clinic. The variables of age, sex, presence of risk factors, alpha angle, beta angle, and degree of dysplasia (according to the Graf scale) were analyzed.

Definition of Study Population: Children under 6 months and older than 4 weeks attended at the ultrasound clinic, both boys and girls. The exclusion criteria were repeated records, patients over 6 months of age, and patients who started the registration process but did not undergo ultrasound, resulting in a sample size of n=2678.

RESULTS: Of the 2678 patients studied, 55% were female and 45% male, with an average age of 2 months at the time of the study, ranging from 3 days to 6.3 months. On average, patients were born at 38.8 weeks of gestation. 268 patients had at least one risk factor for DDH as reported in the literature. However, the majority had no risk factors. Seventy-four patients presented with 2 risk factors, and 62 had 3 risk factors for DDH. Statistically significant factors included female sex, breech presentation, and family history of DDH. The referral reasons for the ultrasound clinic were analyzed, with 235 patients referred due to positive Barlow and Ortolani maneuvers during the initial assessment by a pediatrician or general practitioner. Specific data for each maneuver could not be obtained as it was not specified in all referrals. Within the clinically suspected group, 123 patients were classified as Graf IIB or higher, and it is noteworthy that within the group without clinical suspicion, 81 patients were diagnosed with hip dysplasia.

CONCLUSIONS: Early detection of DDH is crucial for the prevention of pain or disability in adulthood. The use of universal screening is important and useful for appropriately detecting cases, and as shown in this study, it should not be exclusive to patients with clinical suspicion or risk factors.