Ultrasound screening for hips at risk in developmental dysplasia : Is it worth it ?
Between May 1992 and April 1997, there were 20 452 births in the Blackburn District.
In the same period 1107 infants with hip'at-risk'factors were screened prospectively by ultrasound.
We recorded the presence of dislocation and dysplasia detected under the age of six months using Graf's alpha angle.
Early dislocation was present in 36 hips (34 dislocatable and 2 irreducible).
Of the 36 unstable hips, 30 (83%) were referred as being Ortolani-positive or unstable ; 25 (69%) of these had at least one of the risk factors.
Only 11 (31%) were identified from the'at-risk'screening programme alone (0.54 per 1000 live births).
Eight cases of'late'dislocation presented after the age of six months (0.39 per 1000 live births).
The overall rate of dislocation was 2.2 per 1000 live births.
Only 31% of the dislocated hips belonged to a major'at-risk'group.
Statistical analysis confirmed that the risk factors had a relatively poor predictive value if used as a screening test for dislocation.
In infants referred for doubtful clinical instability, one dislocation was detected for every 11 infants screened (95% confidence interval (CI) 8 to 17) whereas in infants referred because of the presence of any of the major'at-risk'factors the rate was one in 75 (95% CI 42 to 149). (...)
Mots-clés Pascal : Luxation, Hanche, Congénital, Imagerie ultrasonore, Dépistage, Facteur risque, Epidémiologie, Etude longitudinale, Nourrisson, Homme, Analyse corrélation, Diagnostic, Dysplasie, Système ostéoarticulaire pathologie, Arthropathie, Malformation, Exploration ultrason
Mots-clés Pascal anglais : Luxation, Hip, Congenital, Ultrasound imaging, Medical screening, Risk factor, Epidemiology, Follow up study, Infant, Human, Correlation analysis, Diagnosis, Dysplasia, Diseases of the osteoarticular system, Arthropathy, Malformation, Sonography
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 99-0218786
Code Inist : 002B24C04. Création : 16/11/1999.