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Diagnosis of congenital hip dysplasia in the newborn
- Source :
- Acta Orthopaedica. 79:313-320
- Publication Year :
- 2008
- Publisher :
- Medical Journals Sweden AB, 2008.
-
Abstract
- Screening of newborn infants for congenital hip dysplasia may be done by clinical examination, ultrasound, or radiography--or a combination of these. Studies that have used clinical examination followed by ultrasound imaging for infants with certain risk factors have shown excellent results, but they were performed by very experienced practitioners. We wanted to find out whether the results of such screening would be equally good with less optimal staffing. Thus, we evaluated the real-life performance of a screening program for detection of congenital hip dysplasia in newborn infants.We performed a retrospective chart review of all infants (n = 1,983) referred for evaluation for suspected congenital hip dysplasia from one single obstetric hospital, where 19,820 infants had been screened from 1992 through 2001. Infants were referred either because of a positive finding during the Ortolani and Barlow examinations or because of the presence of risk factors.The reasons for referral of the 1,983 infants (10% of those examined) were: positive clinical signs in 255 (1.3% of all examined) and risk factors in 1,547 (7.8%), and a combination of both in 114 (0.6%). 67 other infants (0.3%) who had passed the initial pediatric screening were later referred from the local health centers. Finally, 23 of the 1,983 infants were subsequently referred again by their health center for renewed orthopedic evaluation. Of the infants who were treated (298/1,983 = 15% of those referred), those with a pathological examination result were represented proportionately more than infants who were referred because of risk factors (0.8% as opposed to 0.5%). Delayed diagnoses occurred in 1.7/1,000 infants.The performance of a screening protocol for congenital hip dysplasia in a real-life setting involving several physicians both on the pediatric and orthopedic side may not live up to expectations based on the use of such a protocol in an optimized setting. This type of analysis of screening data may serve to pinpoint weaknesses, and thus lead to adjustments that may enhance quality.
- Subjects :
- Pediatrics
medicine.medical_specialty
Physical examination
Sensitivity and Specificity
Neonatal Screening
Predictive Value of Tests
Risk Factors
Traction
Humans
Medicine
Orthopedics and Sports Medicine
Hip Dislocation, Congenital
Referral and Consultation
Retrospective Studies
Ultrasonography
Hip dysplasia
medicine.diagnostic_test
business.industry
Ultrasound
Infant, Newborn
Retrospective cohort study
General Medicine
medicine.disease
Early Diagnosis
Predictive value of tests
Orthopedic surgery
Surgery
Clinical Competence
business
Positive Finding
Follow-Up Studies
Congenital hip dysplasia
Subjects
Details
- ISSN :
- 17453682 and 17453674
- Volume :
- 79
- Database :
- OpenAIRE
- Journal :
- Acta Orthopaedica
- Accession number :
- edsair.doi.dedup.....0fea034398237819715318b0b7deb118