MR-based parameters as a supplement to radiographs in managing developmental hip dysplasia.

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Abstract

[Indexed for MEDLINE] Conflict of interest statement: No potential conflict of interest relevant to this article was reported. 18. Med Sci (Basel). 2025 Dec 10;13(4):311. doi: 10.3390/medsci13040311. Universal Hip Ultrasound Screening in Newborns: A 21-Month Prospective Observational Study in a Spoke Center. Ragusa N(1), Gianotto NR(1), Deut V(1), Mattivi C(1), Compagno F(1), Cherubini Scarafoni M(1), Dominici S(1), Berger M(1). Author information: (1)Pediatrics and Neonatology Department, Ivrea Hospital, Piazza Credenza 2, ASLTO4, Piedmont, 10015 Ivrea, Italy. Background: Developmental dysplasia of the hip (DDH) encompasses a spectrum of neonatal hip abnormalities that, if not detected and treated early, may lead to long-term orthopedic sequelae. Universal ultrasound screening using Graf's method has been proposed to improve early diagnosis, though its implementation remains heterogeneous in Italy. Objectives: This study aimed to describe the outcomes of a universal ultrasound screening program for DDH conducted in a first-level birth center in northern Italy, evaluating DDH incidence, risk factors, management outcomes, and program feasibility. Methods: A prospective observational study was conducted from February 2024 to October 2025 at the Ivrea birth center (Piedmont region, Italy). All consecutive live-born infants (n = 904) underwent hip ultrasound according to Graf's method, between 0 and 11 weeks of age. Hips were classified as type I (normal), type IIa (physiologically immature), or type IIb-IV (pathological). Infants with type IIa hips were re-evaluated after 2-4 weeks; those with type IIb or worse were referred to pediatric orthopedics. Results: Of 1808 hips examined, 92% were Graf type I and 8% type IIa. After follow-up, 93% of type IIa hips matured spontaneously. Pathological DDH (Graf IIb or worse) was diagnosed in 8 infants (0.88%), of whom 75% were female; 50% had no identifiable risk factors. All affected infants were treated with harness before 12 weeks of age, with complete recovery and no late diagnoses. No infant required surgical treatment. Conclusions: Universal ultrasound screening for DDH was feasible and effective in a first-level birth center, ensuring early diagnosis and absence of late-presenting cases. These findings support universal screening as a safe and equitable approach to reduce DDH-related morbidity and align with national recommendations for standardized early detection programs. DOI: 10.3390/medsci13040311 PMCID: PMC12734909