Ultrasound and neonatal hip screening: The five-year results of a prospective study in high-risk babies

We present the 5-year results of an ongoing prospective study of static ultrasound scanning for developmental dysplasia of the hip (DDH) to enlarge on and update the findings after the first year of this screening programme. Between January 1988 and December 1992, there were 17,792 births, 2,683 of which had risk factors: 354 babies had abnormal scans. Screening failed in eight cases, two of which were preventable because they had risk factors but were not scanned; however, six cases came from the 85% of babies without risk factors. The incidence of late cases is therefore 0.45 per thousand births. These results indicate that static ultrasound scanning is effective in detecting abnormal hips, but if only the "at risk" group is screened in this way, then there will be an expected rate of late cases of similar to 0.34/1,000. We are concerned with the results of screening (i.e., detection) but not management. We conclude that simple static ultrasound is an effective screening test for DDH but that it should be applied to the whole population and not simply to the "at risk" group.