Developmental dysplasia of the hips – what are we missing?

Developmental dysplasia of the hips (DDH) is one of the conditions screened for in the UK as part of the Newborn and Infant Physical Examination (NIPE) screening programme, however not all cases are detected. We reviewed the electronic records of 286 children attending the dedicated DDH clinic at a tertiary referral centre over a three-year period to identify the proportion of children diagnosed outside of NIPE screening and to compare these children to those diagnosed through screening. In addition, we explored the current literature pertaining to the practice of DDH screening.

Jake Wright
Paediatric Trainee
jake.wright@nhs.net

Aoife Hurley
Neonatal GRID Trainee

Rachel Toone
Neonatal Consultant

Leeds Teaching Hospitals NHS Trust

Wright J., Hurley A., Toone R. Developmental dysplasia of the hips – what are we missing? Infant 2024; 20(2): 55-58.

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Keywords

developmental dysplasia of the hips; DDH; Newborn and Infant Physical Examination; NIPE; screening

Key points

One in five children treated at our centre for DDH were diagnosed outside of screening, with an average delay in diagnosis of 10.7 months.
In our population, children diagnosed later than four months of age were much more likely to require surgical intervention.
Selective ultrasound screening is limited by the sensitivity of the risk factors used and their detection by the examiner.
Universal ultrasound screening may reduce the number of late presentations but does not eliminate them completely and may lead to increased financial and labour costs as well as over treatment and an increased risk of iatrogenic harm.

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