Abstract
Aim
To review the infants in our district general hospital receiving delayed treatment for DDH i.e. those infants who had more than one ultrasound scan prior to diagnosis and treatment. In this group all scans were abnormal at the time of treatment but the scans at first presentation were normal for age when reviewed by our senior radiologist.
Method
An audit was performed of all the children attending our institution from 2008–2011 for treatment of DDH following diagnosis with clinical examination and dynamic ultrasound. A senior radiologist and consultant orthopaedic surgeon independently assessed the scans. Two questions were asked (a) were the scans at the time of treatment normal or abnormal and (b) in those who were treated following a repeat scan, was the initial scan normal.
Results
33 infants were treated for DDH, 8 of whom received treatment after more than one scan. In 3 cases the child had evidence of instability at first examination, 1 had limited abduction and 1 had asymmetrical thigh creases. The remaining 3 had scans that were deemed normal for age by the radiologist but due to suspicion from the treating surgeon they had a repeat examination and scan.
Conclusion
This study although small in numbers highlights the need for a completely normal examination in the presence of a normal ultrasound scan before the diagnosis of DDH can be dismissed.
