ULTRASOUND SCREENING FOR CONGENITAL DISLOCATION OF THE HIP - A LIMITED TARGETED PROGRAM

Abnormal hips, arising from a clinical universal neonatal hip screenin g programme, were referred to a specialist paediatric orthopaedic surg eon for ultrasound (US) assessment. Two different methods of US screen ing were undertaken in consecutive years: (a) Clinically abnormal hips were assessed for dynamic stability without formal assessment of dysp lasia; and (b) Morphologic and dynamic assessment was undertaken in cl inically abnormal and ''at risk'' hips. US has been reported as an acc urate method for initial diagnosis of instability of the hip joint. Th e incidence of late congenital dislocation of the hip (CDH) was not re duced by extending the US programme to include ''at risk groups'' and morphologic assessment of the hips. Morphologic assessment of the hip alone cannot be recommended as a secondary screening programme for the diagnosis of hip dislocation. However, it may be of value in evaluati on of persistent dysplasia and its relationship with dislocation. Targ eted screening programmes may reduce the rate of late CDH requiring op erative procedures; further trials of US are necessary.