Screening of selected risk factors in developmental dysplasia of the hip: an observational study

Background Developmental dysplasia of the hip (DDH) is the most common neonatal musculoskeletal condition. In 2008, the NHS Newborn and Infant Physical Examination committee added selective ‘at risk’ screening to the existing universal neonatal and general practitioner clinical hip screening guidelines. Objective Assessment of breech and family history risk factors in DDH. Design A 15 year prospective, observational, longitudinal cohort study. Method Breech presentation and evidence of a strong family history for DDH were the ‘risk factors’ studied. All infants referred were clinically and sonographically screened by one consultant paediatric orthopaedic surgeon. Results From a cohort of 64 670 live births, 2984 neonates/infants, 46.1 (95% CI 44.6 to 47.8) per 1000 live births, were referred and sonographically screened with these risk factors alone. 1360 were male, of which four were identified as having ‘pathological’ DDH (an incidence of 0.003 (95% CI 0.001 to 0.008)). 1624 were female, of which 45 were identified as having ‘pathological’ DDH (an incidence of 0.028 (95% CI 0.021 to 0.037)). This difference in incidence of 0.025 (95% CI 0.016 to 0.033) was statistically significant (p Conclusions This study questions the current UK screening policy for DDH in clinically stable males referred with risk factors, and may influence future DDH screening programme policy.