Outcome of ultrasonographic hip abnormalities in clinically stable hips

A retrospective review was performed of 192 newborn hips in 112 patients re ferred for hip evaluation. The average age at presentation was 12.7 days, w ith average radiographic follow-up of 15.9 months. Inclusion criteria for o ur study were a normal physical examination of the hip without evidence of instability and an ultrasound examination that was considered abnormal. Pav lik harness treatment was chosen at the discretion of the treating physicia n. At final follow-up, dysplasia was defined as greater than two standard d eviations above the mean acetabular index (AI) for age. Group I consisted o f 43 hips that had Pavlik treatment, and group Il consisted of 149 hips tha t did not receive treatment. There was no difference in these two groups wi th respect to risk factors for dysplasia or the initial abnormalities seen on ultrasound evaluation, although patients in group I had less coverage of the femoral head during stress maneuvers. No hip in group I and two (1.3%) hips in group II were considered dysplastic (AI > 2 SD) at final radiograp hic follow-up (p > 0.10). There was no correlation between the severity of the ultrasound abnormality at birth and the subsequent presence of dysplasi a (p > 0.10). The two hips considered dysplastic on radiograph were not bei ng actively treated. When the hip examination of a newborn hip younger than 1 month is normal, a screening ultrasound does not appear to predict accur ately subsequent hip dysplasia. In this specific setting, an initial screen ing ultrasound may be tao sensitive and does not appear warranted.