Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Oct 24:9:1038066.
doi: 10.3389/fsurg.2022.1038066. eCollection 2022.

Factors for selective ultrasound screening in newborns with developmental dysplasia of the hip ( DDH )

Chanika Angsanuntsukh  1 , Tanyaporn Patathong  1 , Krongkaew Klaewkasikum  1 , Witoon Jungtheerapanich  2 , Tanyawat Saisongcroh  1 , Pornchai Mulpruek  1 , Patarawan Woratanarat  1
Affiliations

Factors for selective ultrasound screening in newborns with developmental dysplasia of the hip ( DDH )

Chanika Angsanuntsukh et al. Front Surg. .

Abstract

Background: Hip ultrasound screening for DDH provides better sensitivity compared to physical examination. Due to a lower prevalence and limited resources, selective hip ultrasound in newborns at risk could be considered a proper screening protocol in Thailand and Asian countries.

Objective: This study was aimed to evaluate risk factors and define criteria for selective screening.

Methods: A case-control study was conducted in 2020. All newborns with hip ultrasound screening were included. Cases were defined as newborns with abnormal hip ultrasounds, while controls were those with normal studies. Inter and intra-rater reliability were evaluated. All factors were analyzed using univariate and multivariate logistic regression. The model performance was tested by Hosmer-Lemeshow goodness of fit. Internal validity was performed by the split data method. Area under the receiver operating characteristic (ROC) curve was estimated.

Results: Ninety-five newborns (29 cases and 66 controls) were included. Eighty percent of cases and 58% of controls were female. The gestational age was 36.6 and 37.7 weeks in case and control, respectively. Female, breech presentation, positive Ortolani test, positive Barlow test, and limited hip abduction were significant factors with odds ratio of 2.82, 5.12, 34.21, 69.64, and 5.48, respectively. The final model included breech presentation, positive Ortolani test, and positive Barlow test. The model cut-off value 15.02 provided sensitivity (93.10%) and specificity were (80.30%). The area under the ROC curve was 0.9308. The split data remained significant internal validity for all factors with p-value < 0.05.

Conclusion: Careful history taking and physical examination are essential to identify the risk factors for DDH. Newborns with breech presentation, positive Ortolani test and positive Barlow test should be screened by hip ultrasound.

Keywords: Barlow test; Ortolani test; breech presentation; hip abduction; risk.

PubMed Disclaimer

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Odds ratio of 4 remained variables.
Figure 2
Figure 2
Area under the receiver operating characteristic (ROC) curve at cutoff value 15.02.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Chan A, McCaul KA, Cundy PJ, Haan EA, Byron-Scott R. Perinatal risk factors for developmental dysplasia of the hip. Arch Dis Child Fetal Neonatal Ed. (1997) 76(2):F94–100. 10.1136/fn.76.2.F94 - DOI - PMC - PubMed
    1. Ibrahim S. Tachdjian's pediatric orthopaedics: from the Texas Scottish rite hospital for children. Malays Orthop J. (2015) 9(1):53. 10.5704/MOJ.1503.012 - DOI
    1. Arti H, Mehdinasab SA, Arti S. Comparing results of clinical versus ultrasonographic examination in developmental dysplasia of hip. J Res Med Sci. (2013) 18(12):1051–5. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3908525/ - PMC - PubMed
    1. Woolacott NF, Puhan MA, Steurer J, Kleijnen J. Ultrasonography in screening for developmental dysplasia of the hip in newborns: systematic review. BMJ (Clin Res ed). (2005) 330(7505):1413. 10.1136/bmj.38450.646088.E0 - DOI - PMC - PubMed
    1. Kural B, Devecioğlu Karapınar E, Yılmazbaş P, Eren T, Gökçay G. Risk factor assessment and a ten-year experience of DDH screening in a well-child population. Biomed Res Int. (2019) 2019:7213681. 10.1155/2019/7213681 - DOI - PMC - PubMed