Clinical practice guideline: Early detection of developmental dysplasia ofthe hip

Developmental dysplasia of the hip is the preferred term to describe the co ndition in which the femoral head has an abnormal relationship to the aceta bulum. Developmental dysplasia of the hip includes frank dislocation (luxat ion), partial dislocation (subluxation), instability wherein the femoral he ad comes in and out of the socket, and an array of radiographic abnormaliti es that reflect inadequate formation of the acetabulum. Because many of the se findings may not be present at birth, the term developmental more accura tely reflects the biologic features than does the term congenital. The diso rder is uncommon. The earlier a dislocated hip is detected, the simpler and more effective is the treatment. Despite newborn screening programs, dislo cated hips continue to be diagnosed later in infancy and childhood,(1-11) i n some instances delaying appropriate therapy and leading to a substantial number of malpractice claims. The objective of this guideline is to reduce the number of dislocated hips detected later in infancy and childhood. The target audience is the primary care provider. The target patient is the hea lthy newborn up to 18 months of age, excluding those with neuromuscular dis orders, myelodysplasia, or arthrogryposis.