TARGETED ULTRASOUND SCREENING FOR DEVELOPMENTAL DYSPLASIA OF THE HIP -THE CHANGING PATTERN OF RISK FACTORS OVER A TEN YEAR PERIOD

Abstract

This study was undertaken between May 1992 and April 2002 in a hospital where there was a targeted screening programme for Developmental Dysplasia of the Hip. All data was collected prospectively. 2,578 infants with clinically unstable or at risk hips underwent bilateral hip ultrasound examination. This was performed by the senior author. At risk hips were considered to be those where there was a history of breech presentation, foot deformity, oligohydramnios on prenatal maternal ultrasound scans or a strong family history of Developmental Dysplasia of the Hip. There were significant changes in the reasons for referral for targeted screening over the ten year period. In the first year of the study 1.5% of referrals were because of oligohydramnios. In the last year of the survey 16.5% of referrals were because of oligohydramnios. The number of referrals for screening because of oligohydramnios increased sixty fold between the first year and last year of the study period. The overall number of infants referred for targeted screening more than doubled between the first and the last year of the study period. Of the infants that were found to have unstable or dislocated hips, no infants had oligohydramnios as a risk factor. The number of referrals for targeted ultrasound screening is increasing. In a targeted screening programme for Developmental Dysplasia of the Hip we suggest that oligohydramnios should not be used as a possible risk factor.