IS CLINICAL EXAMINATION RELIABLE IN DIAGNOSIS OF DEVELOPMENTAL DYSPLASIA OF THE HIP?

Purpose: To assess the sensitivity and specificity of clinical examination compared with ultrasonography (USG) in diagnosing developmental dysplasia of the hip (DDH). Methods: The files of children aged 6 months or younger who were born at the Baskent University Hospitals in the years 2000-2002 were examined. After examination of 443 infants by an experienced paediatrician, an orthopaedic surgeon evaluated all neonate hips by USG. The validity of the clinical examination results versus the validity of the USG examination results was assessed and analysed. Results: Of the 443 children, 55.8% were female and 44.2% were male; 74.7% of the infants having DDH were female and 25.3% were male (P < 0.05). Of the infants with DDH, 8.8% had a family history of the disorder. Analysis of the validity of the clinical examination results compared with USG examination results showed the sensitivity, specificity, (+) and (-) predictive values of clinical assessment to be 38.5%, 84.9%, 39.8%, and 84.2%, respectively. Conclusions: We recommend USG examinations for all infants at high risk for DDH because the examination is non-invasive, repeatable, inexpensive, and has no risk of ionizing radiation. Additionally, there is no need for sedation or contrast material administration.