ULTRASOUND DIAGNOSIS OF NEONATAL CONGENITAL DISLOCATION OF THE HIP A DECISION-ANALYSIS ASSESSMENT

Routine ultrasound evaluation of neonates and young infants for congen ital dislocation of the hip has been recommended. We have used the met hods of decision analysis to determine whether every neonate should be examined by ultrasound or just those at increased risk We have also s tudied the reliability and accuracy of ultrasound in following infants during observation and treatment, using published data. We find that ultrasound is not the preferred strategy for the screening of neonates , and that its role in evaluating high-risk patients depends on the po int of view. For an individual, when third parties are bearing the cos t, ultrasound is useful. For society as a whole, the routine ultrasoun d evaluation of the high-risk patient is not advantageous. For follow- up, ultrasound using the methods of Graf has a low reliability and the re are no adequate data for methods using dynamic assessment.