Background: Clinical examination, while useful, has been shown to be insuffici ent as the sole screening method in infants. Ultrasound examination at 8 weeks i n high risk infants is an integral part of the screening ...Background: Clinical examination, while useful, has been shown to be insuffici ent as the sole screening method in infants. Ultrasound examination at 8 weeks i n high risk infants is an integral part of the screening process in some units. Aims: To snow the efficiency of hip sonography in detection of developmental dys plasia of the hips in those without clinically dislocated hips. Methods: All inf ants born at the National Maternity Hospital between January 1994 and December 2 001 were included. All those with clinically dislocated hips were treated by a P avlik harness and referred for follow up to a paediatric orthopaedic surgeon. An 8 week hip ultrasound scan was performed for those infants with stable hips on examination but who met the following criteria: (1) a first degree relative with congenital dislocation of hips; (2) breech presentation at birth; and (3) a per sistent “click”at birth in an otherwise stable hip. Results: During the period of study a total of 52 893 infants were born in the National Maternity Hospital . Based on the criteria above, 5485 hip ultrasound scans were performed. Of thos e scanned, 18 (0.33%)were found to have dislocated hips and 153 (2.78%)-to ha ve dysplasic hips. The 18 infants with dislocation were treated with Pavlik harn ess; the remaining 153 were followed up by serial ultrasound examinations but di d not require active intervention. Conclusions: Among the population of infants at increased risk of developmental dysplasia of the hip, the hip screening progr amme identified 18 cases among 5485 infants; a rate of 3.2 per 1000. Hip sonogra phy is therefore worthwhile.展开更多
文摘Background: Clinical examination, while useful, has been shown to be insuffici ent as the sole screening method in infants. Ultrasound examination at 8 weeks i n high risk infants is an integral part of the screening process in some units. Aims: To snow the efficiency of hip sonography in detection of developmental dys plasia of the hips in those without clinically dislocated hips. Methods: All inf ants born at the National Maternity Hospital between January 1994 and December 2 001 were included. All those with clinically dislocated hips were treated by a P avlik harness and referred for follow up to a paediatric orthopaedic surgeon. An 8 week hip ultrasound scan was performed for those infants with stable hips on examination but who met the following criteria: (1) a first degree relative with congenital dislocation of hips; (2) breech presentation at birth; and (3) a per sistent “click”at birth in an otherwise stable hip. Results: During the period of study a total of 52 893 infants were born in the National Maternity Hospital . Based on the criteria above, 5485 hip ultrasound scans were performed. Of thos e scanned, 18 (0.33%)were found to have dislocated hips and 153 (2.78%)-to ha ve dysplasic hips. The 18 infants with dislocation were treated with Pavlik harn ess; the remaining 153 were followed up by serial ultrasound examinations but di d not require active intervention. Conclusions: Among the population of infants at increased risk of developmental dysplasia of the hip, the hip screening progr amme identified 18 cases among 5485 infants; a rate of 3.2 per 1000. Hip sonogra phy is therefore worthwhile.
