ACR Appropriateness Criteria® on Developmental Dysplasia of the Hip-Child

Boaz K. Karmazyn, Richard B. Gunderman, Brian D. Coley, Ellen R. Blatt, Dorothy Bulas, Lynn Fordham, Daniel J. Podberesky, Jeffrey Scott Prince, Charles Paidas, William Rodriguez

Research output: Contribution to journalReview article

26 Scopus citations

Abstract

Developmental dysplasia of the hip (DDH) affects 1.5 of every 1,000 caucasian Americans and less frequently affects African Americans. Developmental dysplasia of the hip comprises a spectrum of abnormalities, ranging from laxity of the joint and mild subluxation to fixed dislocation. Early diagnosis of DDH usually leads to low-risk treatment with a harness. Late diagnosis of DDH in children may lead to increased surgical intervention and complications. Late diagnosis of DDH in adults can result in debilitating end-stage degenerative hip joint disease. Screening decreases the incidence of late diagnosis of DDH. Clinical evaluation for DDH should be performed periodically at each well-baby visit until the age of 12 months. There is no consensus on imaging screening for DDH. Consideration for screening with ultrasound is balanced between the benefits of early detection of DDH and the increased treatment and cost factors. In addition, randomized trials evaluating primary ultrasound screening did not find significant decrease in late diagnosis of DDH. In the United States, hip ultrasound is selectively performed in infants with risk factors, such as family history of DDH, breech presentation, and inconclusive findings on physical examination. Ultrasound for DDH should be performed after 2 weeks of age because laxity is common after birth and often resolves itself. A pelvic radiograph can optimally be performed after the age of 4 months, when most infants will have ossification centers of the femoral heads.

Original languageEnglish (US)
Pages (from-to)551-557
Number of pages7
JournalJournal of the American College of Radiology
Volume6
Issue number8
DOIs
StatePublished - Aug 2009

Keywords

  • ACR Appropriateness Criteria
  • development dysplasia of the hip
  • dislocation
  • pediatric
  • screening
  • subluxation
  • ultrasound

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

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    Karmazyn, B. K., Gunderman, R. B., Coley, B. D., Blatt, E. R., Bulas, D., Fordham, L., Podberesky, D. J., Prince, J. S., Paidas, C., & Rodriguez, W. (2009). ACR Appropriateness Criteria® on Developmental Dysplasia of the Hip-Child. Journal of the American College of Radiology, 6(8), 551-557. https://doi.org/10.1016/j.jacr.2009.04.008