IN DEVELOPMENTAL dysplasia of the hip (DDH), normal hip development depends on attainment of early concentric reduction of the femoral head. Neonatal screening for DDH by means of physical examination has resulted in a marked reduction of late diagnoses. Since the hip early in infancy is predominantly cartilaginous and visible with ultrasound, different imaging strategies using ultrasound have been proposed to further reduce the incidence of late diagnosis of DDH. However, concerns have been raised about the effectiveness of ultrasound in eliminating late diagnosis of DDH.1
In this issue, Rosendahl et al2 address the cost-effectiveness of three strategies in the evaluation of DDH. The analysis is based on a previously reported "randomized" clinical trial3 in which patients underwent evaluation according to three protocols: clinical examination alone, ultrasonographic examination in infants with high risk factors, and general screening with ultrasound. In that trial,3 no difference in
Hernandez R, Hensinger RN. Developmental Dysplasia of the Hip and Ultrasound: More Is Less? Arch Pediatr Adolesc Med. 1995;149(6):641–642. doi:https://doi.org/10.1001/archpedi.1995.02170190051008
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