How successful is screening for congenital disease of the hip?

The efficacy of neonatal screening for congenital disease of the hip is reviewed in relation to currently accepted criteria. There is poor validity of the tests used, imperfect understanding of the natural history of the condition, and absence of information on the outcome of treatment following screening compared to that following conventional diagnosis. The benefits of screening, although probably real, are therefore difficult to quantify. Strategies for increasing the efficiency of screening (maximizing the benefit:cost ratio) by mass screening after the neonatal period or by instituting routine retesting of all infants are discussed.