Radiography (London, England : 1995) · 2026
Developmental dysplasia of the hip and macrosomia: a retrospective ultrasound audit in a secondary healthcare facility in the United Kingdom.
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Onu I U, Ollawa C U, Turner A, Dartnell J, Ridley S, Ohuegbe C, Katchburian M
Аннотация
INTRODUCTION: Developmental dysplasia of the hip (DDH) is a common paediatric musculoskeletal condition, and early detection improves outcomes. While established perinatal risk factors inform selective ultrasound screening in the United Kingdom, the role of high birthweight (macrosomia) remains uncertain. This study aimed to quantify the absolute prevalence of DDH in macrosomic female infants undergoing selective ultrasound screening.
METHODS: A retrospective cross-sectional audit was conducted of 681 female infants (1362 hips) with recorded birthweight ≥ 4 kg who underwent ultrasound hip screening using the Graf technique between 2019 and 2022 at a UK secondary care centre. DDH was defined as Graf types IIb-IV. Prevalence was calculated per 1000 infants with 95% Wilson confidence intervals. Treatment pathways and outcomes were descriptively analysed.
RESULTS: DDH was identified in 101 infants, giving a prevalence of 14.8% (140.3 per 1000; 95% CI 12.3-17.7). Of 123 dysplastic hips, 91.1% were managed with a Pavlik harness, with a treatment success rate of 96.4%. Left-sided dysplasia was slightly more common than right-sided involvement. Continuous infant-level birthweight data were not available beyond the eligibility threshold, and dose-response or correlation analyses were therefore not performed.
CONCLUSIONS: Macrosomic female infants undergoing selective ultrasound screening demonstrated a high absolute prevalence of DDH. While causal inference is limited by the absence of a non-macrosomic comparator group, these findings suggest that macrosomia may represent a clinically relevant risk marker warranting further prospective evaluation.
IMPLICATIONS FOR PRACTICE: These findings suggest that incorporating birthweight ≥ 4 kg into UK selective ultrasound criteria may reduce late diagnoses.
METHODS: A retrospective cross-sectional audit was conducted of 681 female infants (1362 hips) with recorded birthweight ≥ 4 kg who underwent ultrasound hip screening using the Graf technique between 2019 and 2022 at a UK secondary care centre. DDH was defined as Graf types IIb-IV. Prevalence was calculated per 1000 infants with 95% Wilson confidence intervals. Treatment pathways and outcomes were descriptively analysed.
RESULTS: DDH was identified in 101 infants, giving a prevalence of 14.8% (140.3 per 1000; 95% CI 12.3-17.7). Of 123 dysplastic hips, 91.1% were managed with a Pavlik harness, with a treatment success rate of 96.4%. Left-sided dysplasia was slightly more common than right-sided involvement. Continuous infant-level birthweight data were not available beyond the eligibility threshold, and dose-response or correlation analyses were therefore not performed.
CONCLUSIONS: Macrosomic female infants undergoing selective ultrasound screening demonstrated a high absolute prevalence of DDH. While causal inference is limited by the absence of a non-macrosomic comparator group, these findings suggest that macrosomia may represent a clinically relevant risk marker warranting further prospective evaluation.
IMPLICATIONS FOR PRACTICE: These findings suggest that incorporating birthweight ≥ 4 kg into UK selective ultrasound criteria may reduce late diagnoses.