Pilot evaluation of anterior dynamic ultrasound screening for developmental dysplasia of the hip in an Australian Regional Hospital
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Charlton, S and Muir, L and Skinner, TC and Walters, L, Pilot evaluation of anterior dynamic ultrasound screening for developmental dysplasia of the hip in an Australian Regional Hospital, Rural and Remote Health, 12, (3) Article 2091. ISSN 1445-6354 (2012) [Refereed Article]
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Copyright 2012 S Charlton, L Muir, TC Skinner, L Walters
Introduction: Developmental Dysplasia of the Hip (DDH) is the most common notifiable musculoskeletal birth defect in South
Australia (SA). Despite routine screening by physical examination of the hips in the neonatal period and at 6 weeks of age, the risk of
late diagnosis is increased in rural areas. It is assumed this is due to the examining doctors’ reduced clinical expertise. Introducing
Anterior Dynamic Ultrasound (ADUS) has reduced the late detection rates in Sweden to almost zero, and may benefit Australian
infants in rural areas if routine screening was introduced. This study reports on a small implementation pilot in a SA regional hospital
where volunteer postnatal mothers consented to their babies having ADUS examinations.
Methods: The pilot was evaluated by collecting results of physical examination, ADUS, and surveying parental impressions of the
Results: Hips of 86 infants underwent ADUS during the implementation pilot. Parents’ perceptions were mainly very positive and
indicated ADUS was an accessible and acceptable screening test. Of the hips scanned, three were found to have maximum
© S Charlton, L Muir, TC Skinner, L Walters, 2012. A licence to publish this material has been given to James Cook University, http://www.rrh.org.au
movement of the femoral head of >3 mm and were deemed to demonstrate increased laxity. Four hips described as loose or mobile
on clinical examination were found to be within normal limits of maximum mobility on ADUS.
Conclusions: This study has demonstrated that a larger scale implementation project would be feasible in regional Australia, and
would enable researchers to better understand how to reduce the late diagnosis rate of DDH in rural areas.
Key words: Australia, congenital, hip dislocation, mass screening, ultrasound.
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