Olsen SF, et al. – An analysis was conducted to evaluate the impact of adding an ultrasound examination to a one examiner clinical screening strategy on treatment, follow-up rates and the number of cases detected late in a low-prevalence population. Findings suggested that adding universal ultrasound to clinical screening performed by the same, experienced paediatrician doubled the treatment rate, without influencing the already low numbers of late cases.

Methods

• In this study, all eligible babies born at Kongsberg Hospital, Norway, from 1998-2006 (n=4,245) underwent both clinical and ultrasound hip examinations within three days of life.
• Indications for immediate treatment were positive Barlow or Ortolani manoeuvures and, or, sonographic dysplasia. 
• Sonographic immature hips were followed until normalisation. 
• From hospital records, treatment rates and rates from the 1989-97 pre-study period (n=3,594), including late diagnoses were accumulated.

Results

• Treatment was initiated in 90 (2.1%) infants (74 girls), 63 (70%) from birth, compared to 33 (0.9%) during the pre-study period. 
• The follow-up rate did not change (11%).
• There were two (0.5 per 1,000) and four (1.0 per 1,000) cases detected late, respectively. 
• During the first year of life, no-one underwent surgery.
• No avascular necrosis was reported.