Addressing the limitations of neonatal screening
Unreliability of neonatal examination and ultrasound for diagnosing DDH
In a retrospective cohort study conducted in Melbourne, Australia, researchers examined the effectiveness of neonatal clinical examination and selective ultrasound screening as tools for diagnosing DDH.
Despite the utilisation of a selective ultrasound screening program (those infants with known risks for DDH or abnormal clinical findings) the research team discovered that only approximately half of all DDH cases were detected early in infancy. In contrast, most infants who had ultrasounds from selective screening did not have DDH.
The study also found that skin crease asymmetry, a specific clinical sign, was more common with later presentation. While breech presentation and positive Barlow/Ortolani test were associated with early presentation.
Furthermore, infants with DDH, whether diagnosed early or late, displayed similar clinical characteristics and the incidence of DDH is higher than previously reported in Australian studies.
These findings highlight the ongoing challenges in achieving reliable DDH screening in newborns and emphasise the need for an alternative approach to neonatal screening methods. At the same time, community healthcare providers must maintain careful clinical monitoring of infant hips throughout the child's first year of life and beyond.
Read the full article published in the Journal of Paediatrics and Child Health in August 2023. Mr Mitchell Johnson, A/Prof Carl Kuschel and A/Prof Leo Donnan, VicHip’s lead Principal Investigator, collaborated on the paper.
Journal of Paediatrics and Child Health, 7 August 2023 Neonatal clinical examination and selective ultrasound screening are not reliable for the early diagnosis of hip dysplasia: A retrospective cohort study. Johnson MD, Kuschel C, Donnan L. Neonatal clinical examination and selective ultrasound screening are not reliable for the early diagnosis of hip dysplasia: A retrospective cohort study. J Paediatr Child Health. 2023 Aug 7. doi: 10.1111/jpc.16472. Epub ahead of print. PMID: 37545325.
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VicHip is funded by the Australian Government Department of Health and Aged Care under the Medical Research Future Fund grant 2015989.
Murdoch Children's Research Institute acknowledges the Traditional Custodians of lands on which we work and pay our respect to their Elders, past, present and emerging.