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An audit of referral time frames for ultrasound screening of developmental hip dysplasia in neonates with a normal antenatal clinical examination
Author(s) -
Burnett Madonna,
Rawlings Emma Louise,
Reddan Tristan
Publication year - 2018
Publication title -
sonography
Language(s) - English
Resource type - Journals
eISSN - 2054-6750
pISSN - 2202-8323
DOI - 10.1002/sono.12147
Subject(s) - medicine , overdiagnosis , referral , ultrasound , medical record , pediatrics , physical examination , acetabulum , audit , obstetrics , radiology , surgery , family medicine , economics , management
Ultrasound has an established role in the detection of developmental dysplasia of the hip (DDH). Lack of uniformity in the appropriate age to perform studies in at‐risk children with a normal clinical examination at birth exists. Opening a new tertiary paediatric hospital saw a variety of referral time frames for initial screening ultrasound for DDH. Methods Literature review and retrospective clinical audit were undertaken. DDH ultrasounds of babies with the following criteria were reviewed: normal clinical examination and one or more risk factors. Patients were followed up via their electronic medical record. Results There were 187 eligible patients: 124 (66.3%) had normal initial scans while 63 (33.7%) were recommended to have a follow‐up scan. Most subnormal results (Graf 2A or lower, laxity and/or less than 50% femoral head coverage) ( n = 59, 93.7%) were scanned before 6 weeks of age, only four (6.3%) presented at 5 weeks after birth or later. Discussion This study identified a potential for reduction in follow‐up studies through delayed initial ultrasound, improving from 4 to 6 weeks of age, without adverse outcomes. Early screening ultrasounds may result in overdiagnosis of DDH during the maturation process of the neonatal acetabulum, potentially causing anxiety and unnecessary follow‐up.