Do we need to follow up an early normal ultrasound with a later plain radiograph in children with a family history of developmental dysplasia of the hip?

• Published in: European journal of orthopaedic surgery & traumatology 2015-10, Vol.25 (7), p.1171-1175
• Main Authors: Tafazal, Suhayl, Flowers, Mark J.
• Format: Article
• Language: English
• Subjects: Child, Preschool; Female; Follow-Up Studies; Hip Dislocation, Congenital - diagnostic imaging; Humans; Infant; Infant, Newborn; Male; Medicine; Medicine & Public Health; Original Article • HIP - PAEDIATRICS; Radiography; Retrospective Studies; Surgical Orthopedics; Traumatic Surgery; Ultrasonic imaging; Ultrasonography
• ISSN: 1633-8065; 1432-1068
• DOI: 10.1007/s00590-015-1668-4

Background We routinely perform a pelvic radiograph between 6 and 12 months of age for children with a family history of developmental dysplasia of hip (DDH). We conducted this study to determine whether children with a family history of DDH and a normal hip ultrasound after birth require any further radiological follow-up. Methods We identified all children referred to our hip-screening clinic in a 3-year period between August 2008 and August 2011 with a family history of DDH and a normal hip ultrasound after birth. A total of 119 patients with a normal hip ultrasound after birth had a pelvic radiograph at a median age of 6.6 months. Results Six patients had residual dysplasia (acetabular index >30°) on the initial radiograph; five of these had resolved spontaneously by age 12 months, and the remaining patient had a normal radiograph at 21 months of age and was discharged. Conclusion We have found no cases of residual hip dysplasia requiring treatment in children with a family history of DDH and a normal hip ultrasound after birth. We have therefore changed our practice accordingly and no longer routinely followed up such cases. Level of evidence Diagnostic study, Level II.