Family history in developmental dysplasia of the hip: should we follow-up?
Journal Title: The European Research Journal - Year 2019, Vol 5, Issue 6
Abstract
Objectives: Developmental dysplasia of the hip (DDH) is an important problem. Ultrasonography (US) is a proper method before 6 months of age. For older children, plain radiographs can be useful. Six risk factors are emphasized: breech presentation, female sex, a positive family history, being first-born, left hip affected, and mode of delivery. In some centers, clinicians prefer to perform a control US examination or pelvic radiographs after 6 months of age for the children having a positive family history. We aimed to evaluate the necessity of control US/direct radiography examinations. Methods: A total of 205 children with a positive family history for DDH are included. US examinations are performed according to Graf’s method. We have evaluated direct radiographs by using Hilgenreiner, Perkin, and Shenton lines, acetabular angle. Results: Initial US examinations are performed at a median age of 8.3 weeks. Seventy-four patients (36%) had a repeat ultrasound scan at a median age of 7 months; none of them demonstrated abnormal findings. One hundred and thirty-one patients (63.9%) had control radiographs at a median age of 8.2 months. Shenton line is considered as normal, and the upper femoral epiphysis is located in inferomedial quadrant according to Hilgenreiner and Perkin lines. Conclusions: A positive family history for DDH may be a less important reason for performing control US or radiographic examination. Patients with a normal screening US result and having risk factors can be discharged from follow up safely, so that unnecessary examinations and family anxiety will be reduced.
Authors and Affiliations
Sonay Aydın, Erdem Fatihoğlu
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