Screening for Developmental Dysplasia of the Hip: A Systematic Literature Review, Table 3. Population-based Comparative Studies: Clinical Exam Versus Ultrasound Risk Factors

You Are Here: AHRQ Home > Clinical Information > U.S. Preventive Services Task Force > Topic Index > Screening: Developmental Dysplasia of the Hip > Systematic Literature Review

Author, Year	N	Clinical examiners (Number of Examiners)	Reference standard for DDH	Clinical exam instability rate/ 1000 children	Ultrasound positive rate/ 1,000 children	Treatment rate/ 1000 children	% with DDH identified only by exam	% with DDH identified only by ultrasound	% with pos. exam and neg. ultrasound*	Late diagnosis rate/ 1000 children	Rate/ timing of spontaneous resolution	Followup of initially negative tests
Bache, 2002	29,323	Not specified	Requires intervention	NR	65.9 (hips) (39 subluxable/ dislocated)	3.1 (hips)	0%	65%	18%	0	96% of hips with ultrasound abnormalities at birth by 6 weeks	Unclear
Blalik, 1998	4321	Neonatologist (NR)	Requires intervention	15.2	55.3	6.2 (hips)	0%	52%	2%	NR	90.3% of hips with dysplasia or instability by 6 weeks	NR
Giannakopoulou, 2002	6140	Pediatrician (2)	Ultrasound: abnormality	17.9	12.2	10.6	NA	32%	41%	NR	10/75 hips (10/10 with physiological dysplasia) within 4 weeks	NR
Paton, 1999	20,452	Pediatrician (NR)	Ultrasound: dislocation	14	1.8	NR	NA	31%	87%	0.4	NR	Unclear
Riboni, 2003	8896	Neonatologist (NR)	Ultrasound: abnormality	2.1	28	3.8	NA	56%	58%	2.1 DDH/ 0.6 more severe than dysplasia	206/215 with borderline dyplasia by 1 month	Yes (83%), at 3 months
Rosenberg, 1998	9199	Neonatologist (NR)	Clinical exam or ultrasound: instability	14.5	68.2	NR	5%	50%	NA	NR	NR	NR
Rosen-Dahl, 1996	3613	Physicians with > 2 yrs pediatric experience (8)	Clinical exam: dislocatable Ultrasound: "major" dyplasia	19.1	30.4 (23.8 dislocatable/ dislocated)	34	11%	28%	38%	0.2	13/16 with minor dysplasia by 1-2 months	Unclear

Notes: NR, not reported; NA, not applicable.
*Independent of standard used for diagnosis of DDH.