Developmental Dysplasia of the Hip.

Journal and index pages often block iframe embedding. This reader keeps the evidence details in Orthonotes and leaves the source page one click away.

Abstract

[Indexed for MEDLINE] 8. ANZ J Surg. 2025 Mar;95(3):557-563. doi: 10.1111/ans.70000. Epub 2025 Feb 14. Ultrasound for hip dysplasia - disparities between community and tertiary paediatric services. Zhu Y(1), Feng M(2), Seth I(2), Ganeshalingam R(3), Hoq M(4), Donnan LT(5). Author information: (1)Royal Melbourne Hospital, Murdoch Children's Research Institute, Flemington Road, Parkville, Victoria, Australia. (2)Murdoch Children's Research Institute, Monash University. (3)Department of Orthopaedics, University Hospital Geelong, Murdoch Children's Research Institute. (4)Department of Clinical Epidemiology and Biostatistics, Royal Children's Hospital, Murdoch Children's Research Institute. (5)Department of Orthopaedics, Royal Children's Hospital, Murdoch Children's Research Institute. OBJECTIVE: Explore the differences in ultrasound reporting between community ultrasound centres and a high-volume paediatric tertiary centre in diagnosing developmental dysplasia of the hip (DDH). PARTICIPANTS: One hundred infants less than 6 months of age from a paediatric hip registry, who underwent ultrasounds in both community and tertiary centres within a 2-week interval. RESULTS: One percent of a 200-hip sample reported scan quality. Alpha angles were reported in 84.5% (n = 169) of community reports and 78.5% (n = 157) of tertiary centre reports. Femoral head coverage was reported similarly in both environments at 94.5% in community and 93.5% in tertiary. Beta angle appeared in 45% (n = 90) and 2% (n = 4), respectively. Bland Altman plots revealed that there existed variation in ultrasound interpretation especially in more dysplastic hips. The concordance correlation coefficient showed only moderate agreement (Rho = 0.60 for alpha angles, Rho = 0.61 for femoral head coverage), and interrater reliability on hip classification reached moderate agreement (Cohen's Kappa = 0.57 for alpha angle, and 0.45 for femoral coverage) between community and tertiary hospital reports. CONCLUSIONS: Reliance on the community-acquired ultrasound report as a true reflection of the state of a hip is not completely justified. The lack of standardized reporting poses challenges for community clinicians in starting treatment or making appropriate referrals. Only a moderate agreement has been observed between the community and tertiary scans. Consequently, over 25% of hips classified as abnormal are potentially normal, and more than 15% dysplastic hips could be undetected. © 2025 The Author(s). ANZ Journal of Surgery published by John Wiley & Sons Australia, Ltd on behalf of Royal Australasian College of Surgeons. DOI: 10.1111/ans.70000 PMCID: PMC11937750