SENSITIVITY OF MANUAL PALPATION IN TESTING THE NEONATAL HIP

Developmental dysplasia of the hip (DDH) is a term used to describe a group of disorders of the neonatal hip in which the head of the femur is unstable or incongruous in relation to the acetabulum. Early detect ion and treatment of the condition generally results in normal develop ment, whereas late diagnosis has poor success. In Northern Ireland, de spite all neonates being manually examined for hip disorders by a medi cal officer before hospital discharge, there is an unacceptable late d iagnostic rate of almost 50% of all cases. To help reduce the number o f late presentations, vibration arthrometry, a noninvasive form of scr eening for DDH, has been used to record hip vibration events during cl inical testing. In a comparative study, 300 infants were examined by n urses and medical officers to establish the sensitivity of manual palp ation to neonatal hip vibrations detected by the objective detection s ystem. Experienced research nurses detected 86% of the signals; doctor s in training detected less than 10%. This suggests that objective, no ninvasive screening by vibration arthrometry would detect a higher pro portion of vibration events in neonates during the early stages of DDH . More time should be invested in training medical officers and others involved in DDH screening.