[Screening for dysplasia of the hip at health centers].

BACKGROUND

Screening for developmental dysplasia of the hip has a long tradition in health centres in Norway. Under the guidelines from Norwegian health authorities, the presence of asymmetric abduction of the hips should be the most important indication for referral to ultrasound examination. The outcome of this procedure is not well known, however.

MATERIAL AND

METHODS

Throughout the year 2000, all children referred for ultrasound examination of their hips to Ullevaal University Hospital and Oppland Central Hospital Lillehammer were recorded prospectively. The indication for and outcome of the examination of children referred from health centres were examined.

RESULTS

133 girls and 92 boys were referred. Three girls and three boys were identified with dysplasia of the hip, giving an estimated prevalence of 0.5 pr 1,000. Asymmetric abduction of the hip was the most frequent reason for referral with an estimated positive predictive value of 3%. 50 children were examined due to asymmetric femoral skin folds that were probably the only reason for suspecting dysplasia. Two of these children had dysplasia of the hip. 16 children had immature hips necessitating renewed examination, often identifying normal hips.

INTERPRETATION: The screening for developmental dysplasia of the hip at health centres is based on clinical tests or criteria with low positive predictive values.