September 2012. Volume 8. Number 3

Is universal ultrasound more useful than selective ultrasound as screening for developmental dysplasia of the hip?

 
 
 
 
 
 
 
 
 
 
Rating: 0 (0 Votes)
Newsletter Free Subscription
Regularly recieve most recent articles by e-mail
Subscribe
Print
Add to library
Discuss this article

AAP | Making well-informed clinical decisions based on the current scientific evidence: from the article to the patient

Authors: Flores Antón B1, Ortega Páez E2.
1Hospital Universitario de Fuenlabrada. Madrid. España.
2CS Maracena. Distrito metropolitano. Granada. España.
Correspondence: Beatriz Flores Antón. Email: befloan@gmail.com
Reception date: 07/08/2012
Acceptance date: 08/08/2012
Publication date: 22/08/2012

Abstract

Authors’ conclusion: ultrasound strategies aimed at the diagnosis of the developmental dysplasia of the hip, have not demonstrated to improve the results, including late diagnosis of developmental dysplasia of the hip and surgery. However, the included studies are substantially underpowered to detect significant differences in these uncommon events.

Reviewers’ commentary: due to the low incidence of developmental dysplasia of the hip and its consequences (surgery, avascular necrosis of the femoral head, osteoarthritis...), currently there are no studies with sufficient sample size and methodological quality to answer the question. Recent studies, of low methodological quality, report benefit of universal screening to reduce the need for surgery, but do not rule out the possibility that this intervention will increase the need for treatments that in many cases are unnecessary (mild dysplasia resolves spontaneously between 6 weeks and 6 months in >90% of untreated hips) and are not without complications.

How to cite this article

Flores Antón B, Ortega Páez E. ¿Es más útil la ecografía universal que la selectiva para detectar la displasia del desarrollo de la cadera? Evid Pediatr. 2012;8:52.

AAP | Making well-informed clinical decisions based on the current scientific evidence: from the article to the patient

Authors: Flores Antón B1, Ortega Páez E2.
1Hospital Universitario de Fuenlabrada. Madrid. España.
2CS Maracena. Distrito metropolitano. Granada. España.
Correspondence: Beatriz Flores Antón. Email: befloan@gmail.com
Reception date: 07/08/2012
Acceptance date: 08/08/2012
Publication date: 22/08/2012

Sorry, there is no English version for this item.

How to cite this article

Flores Antón B, Ortega Páez E. ¿Es más útil la ecografía universal que la selectiva para detectar la displasia del desarrollo de la cadera? Evid Pediatr. 2012;8:52.

References

  1. Shorter D, Hong T, Osborn DA. Screening programmes for developmental dysplasia of the hip in newborn infants. Cochrane Database Syst Rev. 2011, Issue 9. Art. No.: CD004595.
  2. Shipman SA, Helfand M, Moyer VA, Yawn BP. Screening for developmental dysplasia of the hip: a systematic literature review for the US Preventive Task Force. Pediatrics. 2006;117:e557-e576.
  3. Mahan ST, Katz JN, Kim YJ. To screen or not to screen? A decision analysis of the utility of screening for developmental dysplasia of the hip. J Bone Joint Surg Am. 2009;91:1705-19.
  4. Patel H; Canadian Task Force on Preventive Health C. Preventive health care, 2001 update: screening and management of developmental dysplasia of the hip in newborns. CMAJ. 2001;164:1669-77.
  5. Von Kries R, Ihme N, Altenhofen L, Niethard FU, Krauspe R, Rückinger S. General ultrasound screening reduces the rate of first operative procedures for developmental dysplasia of the hip: a case-control study. J Pediatr. 2012;160:271-5.
  6. Thaler M, Biedermann R, Lair J, Krismer M, Landauer F. Cost-effectiveness of universal ultrasound screening compared with clinical examination alone in the diagnosis and treatment of neonatal hip dysplasia in Austria. J Bone Joint Surg Br. 2011;93:1126-30.
  7. Woolacott NF, Puhan MA, Steurer J, Kleijnen J. Ultrasonography in screening for developmental dysplasia of the hip in newborns: systematic review. BMJ. 2005;330:1413-8.
  8. Roposch A, Moreau NM, Uleryk E, Doria AS. Developmental dysplasia of the hip: quality of reporting of diagnostic accuracy for US. Radiology. 2006;241:854-60.
  9. Perdikis Olivieri L, González de Dios J. El cribado ecográfico de displasia de desarrollo de caderas sólo se justifica en recién nacidos con determinados factores de riesgo. Evid Pediatr. 2005;1:4.
  10. Elbourne D, Dezateux C, Arthur R, Clarke NM, Gray A, et al. Ultrasonography in the diagnosis and management of developmental hip dysplasia (UK Hip Trial): clinical and economic results of a multicentre randomised controlled trial. Lancet. 2002;360(9350):2009-17.
  11. Centre for Reviews and Dissemination. Systematic review of the clinical and cost effectiveness of ultrasound in screening for developmental dysplasia of the hip in newborns. CRD Report 28. York: University of York. 2005.
22/08/2012

Linked Comment