The early diagnosis of congenital hip dysplasia: a proposal for a differentiated echographic screening

Prevention of congenital hip dislocation is one of the main goals of pediatric activity. 839 newborn outpatients, with six months follow-up at least, were recruited at the Pediatric Clinic of the Catholic University of Rome, from January 1991 to December 1992. Every newborn baby was clinically examined for congenital hip dysplasia (CHD) at nursery and afterwards in the ambulatory. Hip sonography was performed, according to Graf's technique, in 504 babies (60%): 17 resulted pathological (3.3%), 30 borderline (6%) and 457 normal (90.7%). Ultrasonographic and clinical findings were compared. Clinical examinations at nursery and ambulatory have shown low sensitivity (21.3% and 34% respectively) in detecting dysplastic hips. Present experience confirms ultrasonography value in the diagnosis of CHD and the utility of its use in a general screening programme.