Family history in developmental dysplasia of the hip: should we follow-up?

Year 2019, Volume: 5 Issue: 6, 957 - 961, 04.11.2019

Sonay Aydın Erdem Fatihoğlu

https://doi.org/10.18621/eurj.442402

Cited By: 1

Abstract

Objectives:
Developmental dysplasia
of the hip (DDH) is an important problem. Ultrasonography (US) is a proper
method before 6 months of age. For older children, plain radiographs can be
useful. Six risk factors are emphasized: breech
presentation, female sex, a positive family history, being first-born, left hip
affected, and mode of delivery. In some centers, clinicians prefer to
perform a control US examination or pelvic radiographs after 6 months of age
for the children having a positive family history. We aimed to evaluate the
necessity of control US/direct radiography examinations.

Methods: A total of 205 children with a positive family history for DDH are
included. US examinations are performed according to Graf’s method. We have
evaluated direct radiographs by using Hilgenreiner, Perkin, and Shenton lines,
acetabular angle.

Results: Initial US examinations are performed at a median age
of 8.3 weeks. Seventy-four patients (36%) had a repeat ultrasound scan at a
median age of 7 months; none of them demonstrated abnormal findings. One hundred
and thirty-one patients (63.9%) had control radiographs at a median age of 8.2
months. Shenton line is considered as normal, and the upper femoral epiphysis
is located in inferomedial quadrant according to Hilgenreiner and Perkin lines.

Conclusions: A positive family history for DDH may be a less
important reason for performing control US or radiographic examination.
Patients with a normal screening US result and having risk factors can be
discharged from follow up safely, so that unnecessary examinations and family
anxiety will be reduced. 

Keywords

Developmental dysplasia of the hip, Graf method, ultrasound, family history, follow-up

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