eMedicine Specialties > Radiology > Pediatrics

Developmental Dysplasia of the Hip: Follow-up

Author: Karen I Norton, MD, Professorial Lecturer, Mount Sinai School of Medicine; Director, Pediatric Radiology, Children's Hospital of New Jersey, Newark Beth Israel Medical Center
Coauthor(s): Sandra A Mitre Polin, MD, Assistant Professor of Radiology, Department of Radiology, Abdominal Imaging and Mammography, Georgetown University Hospital
Contributor Information and Disclosures

Updated: Sep 23, 2009

Intervention

Arthrography can be performed to assess the dislocated hip; often, it is performed at the time of surgical reduction, particularly if the reduction appears to be difficult to maintain. The indications for arthrography are fewer with the development of better sonography, the advent of MRI, and the availability to confirm reductions in spica casts with CT scanning.24,25

Medicolegal Pitfalls

  • In some Western nations, routine screening of all neonates is not performed. Mass screening is not performed in the United States, where only children with abnormal clinical examination findings or those with identified risk factors are examined.
  • Failure to treat clinically insignificant minor abnormalities detected on early US examination may have legal implications in a litigious society; however, the treatment of minor abnormalities that are likely to resolve spontaneously can result in overtreatment and unnecessary medical expenditure.
 


More on Developmental Dysplasia of the Hip

Overview: Developmental Dysplasia of the Hip
Imaging: Developmental Dysplasia of the Hip
Follow-up: Developmental Dysplasia of the Hip
Multimedia: Developmental Dysplasia of the Hip
References
Further Reading
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References

  1. Clinical practice guideline: early detection of developmental dysplasia of the hip. Committee on Quality Improvement, Subcommittee on Developmental Dysplasia of the Hip. American Academy of Pediatrics. Pediatrics. Apr 2000;105(4 Pt 1):896-905. [Medline].

  2. Sankar WN, Weiss J, Skaggs DL. Orthopaedic conditions in the newborn. J Am Acad Orthop Surg. Feb 2009;17(2):112-22. [Medline].

  3. Karmazyn BK, Gunderman RB, Coley BD, Blatt ER, Bulas D, Fordham L, et al. ACR Appropriateness Criteria on developmental dysplasia of the hip--child. J Am Coll Radiol. Aug 2009;6(8):551-7. [Medline].

  4. Krych AJ, Howard JL, Trousdale RT, Cabanela ME, Berry DJ. Total hip arthroplasty with shortening subtrochanteric osteotomy in Crowe type-IV developmental dysplasia. J Bone Joint Surg Am. Sep 2009;91(9):2213-21. [Medline].

  5. 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. Jul 2009;91(7):1705-19. [Medline].

  6. Graf R. Guide to Sonography of the Infant Hip. New York, NY: Thieme Medical; 1987.

  7. McMillan JA, DeAngelis CD, Warshaw JB, et al, eds. Oski's Pediatrics: Principles and Practice. 3rd ed. Philadelphia, Pa: Lippincott Williams & Wilkins; 1999.

  8. Koureas G, Wicart P, Seringe R. Etiology of developmental hip dysplasia or dislocation: review article. Hip Int. 2007;17 Suppl 5:1-7. [Medline].

  9. Gerscovich EO. Infant hip in developmental dysplasia: facts to consider for a successful diagnostic ultrasound examination. Appl Radiol. 1999;Mar:18-25.

  10. Nelson WE, Behrman RE, Kliegman RM, et al. Nelson Textbook of Pediatrics. 15th ed. Philadelphia, Pa: WB Saunders; 1996.

  11. Schwend RM, Schoenecker P, Richards BS, Flynn JM, Vitale M. Screening the newborn for developmental dysplasia of the hip: now what do we do?. J Pediatr Orthop. Sep 2007;27(6):607-10. [Medline].

  12. Hennrikus WL. Developmental dysplasia of the hip: diagnosis and treatment in children younger than 6 months. Pediatr Ann. Dec 1999;28(12):740-6. [Medline].

  13. Fujii M, Nakashima Y, Jingushi S, Yamamoto T, Noguchi Y, Suenaga E, et al. Intraarticular findings in symptomatic developmental dysplasia of the hip. J Pediatr Orthop. Jan-Feb 2009;29(1):9-13. [Medline].

  14. American College of Radiology. ACR Standards, 1999-2000: American College of Radiology Standard for the Performance of the Ultrasound Examination for Detection of Developmental Dysplasia of the Hip. American College of Radiology. Available at http://www.acr.org/cgi-bin/fr?tmpl:standards00,pdf:pdf/hip_dysplasia.pdf. Accessed March 5, 2001.

  15. Graf R. [The use of ultrasonography in developmental dysplasia of the hip.]. Acta Orthop Traumatol Turc. 2007;41 Suppl 1:6-13. [Medline].

  16. Peled E, Eidelman M, Katzman A, Bialik V. Neonatal incidence of hip dysplasia: ten years of experience. Clin Orthop Relat Res. Apr 2008;466(4):771-5. [Medline].

  17. Morin C, Harcke HT, MacEwen GD. The infant hip: real-time US assessment of acetabular development. Radiology. Dec 1985;157(3):673-7. [Medline].

  18. Dezateux C, Rosendahl K. Developmental dysplasia of the hip. Lancet. May 5 2007;369(9572):1541-52. [Medline].

  19. Kirks DR, Griscom NT. Practical Pediatric Imaging Diagnostic Radiology of Infants and Children. Philadelphia, Pa: Lippincott-Raven; 1998.

  20. Ozonoff MB. Pediatric Orthopedic Radiology. 2nd ed. Philadelphia, Pa: WB Saunders; 1992.

  21. Wientroub S, Grill F. Ultrasonography in developmental dysplasia of the hip. J Bone Joint Surg Am. Jul 2000;82-A(7):1004-18. [Medline].

  22. Tudor A, Sestan B, Rakovac I, Luke-Vrbanic TS, Prpic T, Rubinic D, et al. The rational strategies for detecting developmental dysplasia of the hip at the age of 4-6 months old infants: a prospective study. Coll Antropol. Jun 2007;31(2):475-81. [Medline].

  23. AIUM practice guideline for the performance of an ultrasound examination for detection and assessment of developmental dysplasia of the hip. J Ultrasound Med. Jan 2009;28(1):114-9. [Medline].

  24. Kotnis R, Spiteri V, Little C, Theologis T, Wainwright A, Benson MK. Hip arthrography in the assessment of children with developmental dysplasia of the hip and Perthes' disease. J Pediatr Orthop B. May 2008;17(3):114-119. [Medline].

  25. Janssen D, Kalchschmidt K, Katthagen BD. Triple pelvic osteotomy as treatment for osteoarthritis secondary to developmental dysplasia of the hip. Int Orthop. Feb 12 2009;[Medline].

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Further Reading

Related eMedicine topics

 Developmental Dysplasia of the Hip (Orthopedic Surgery)

Fracture, Hip (Emergency Medicine)

Dislocation, Hip (Emergency Medicine)

Hip Dislocation (Sports Medicine)

Hip Fracture (Sports Medicine)


Clinical guidelines
Screening for developmental dysplasia of the hip: recommendation statement. United States Preventive Services Task Force - Independent Expert Panel. 2006. 10 pages. NGC:004705

ACR Appropriateness Criteria® developmental dysplasia of the hip - child. American College of Radiology - Medical Specialty Society. 1999 (revised 2007). 7 pages. NGC:007008

Clinical studies

 Treatment for Mild Hip Dysplasia in Newborns

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Keywords

developmental dysplasia of the hip, DDH, congenital dislocation of the hips, CDH, acetabulum, femoral head, proximal femur, acetabular disorder, myelodysplasia, arthrogryposis

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Contributor Information and Disclosures

Author

Karen I Norton, MD, Professorial Lecturer, Mount Sinai School of Medicine; Director, Pediatric Radiology, Children's Hospital of New Jersey, Newark Beth Israel Medical Center
Karen I Norton, MD is a member of the following medical societies: American College of Radiology, American Roentgen Ray Society, Radiological Society of North America, and Society for Pediatric Radiology
Disclosure: Nothing to disclose.

Coauthor(s)

Sandra A Mitre Polin, MD, Assistant Professor of Radiology, Department of Radiology, Abdominal Imaging and Mammography, Georgetown University Hospital
Sandra A Mitre Polin, MD is a member of the following medical societies: American College of Radiology, Association of University Radiologists, Radiological Society of North America, and Society of Radiologists in Ultrasound
Disclosure: Nothing to disclose.

Medical Editor

Henrique M Lederman, MD, PhD, Consulting Staff, Department of Radiology, LeBonheur Children's Medical Center and St Jude Children's Research Hospital; Professor of Radiology and Pediatric Radiology, Chief, Division of Diagnostic Imaging in Pediatrics, Federal University of Sao Paulo, Brazil
Henrique M Lederman, MD, PhD is a member of the following medical societies: Society for Pediatric Radiology
Disclosure: Nothing to disclose.

Pharmacy Editor

Bernard D Coombs, MB, ChB, PhD, Consulting Staff, Department of Specialist Rehabilitation Services, Hutt Valley District Health Board, New Zealand
Disclosure: Nothing to disclose.

CME Editor

Robert M Krasny, MD, Resolution Imaging Medical Corporation
Robert M Krasny, MD is a member of the following medical societies: American Roentgen Ray Society and Radiological Society of North America
Disclosure: Nothing to disclose.

Chief Editor

John Karani, MBBS, FRCR, Clinical Director of Radiology and Consultant Radiologist, Department of Radiology, King's College Hospital, London
John Karani, MBBS, FRCR is a member of the following medical societies: British Institute of Radiology, British Society of Interventional Radiology, Cardiovascular and Interventional Radiological Society of Europe, European Society of Gastrointestinal and Abdominal Radiology, European Society of Radiology, Radiological Society of North America, and Royal College of Radiologists
Disclosure: Nothing to disclose.

 
 
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