Is clinical examination reliable in diagnosis of developmental dysplasia of the hip?

Özet

Amaç: Bu çalışmanın amacı gelişimsel kalça displazisinin (GKD) tanısında fizik muayenenin sensitivitesinin ve spesifitesinin ultrasonografi (USG) ile değerlendirilmesidir. Gereç ve Yöntem: Bu çalışmada 2000-2002 yılları arasında, Başkent Üniversitesi Hastanesi’nde doğmuş 6 aydan küçük çocukların dosyaları incelenmiştir. 443 yeni doğmuş çocuğun önce klinik muayenesi pediatrist tarafından yapılmış daha sonra ortopedist tarafından USG ile değerlendirilmiştir. Fizik muayene bulgularının USG’ye göre geçerliliği değerlendirilmiş ve analiz edilmiştir. Bulgular: 443 çocuğun %55,8’i kız ve %44,2’si erkekti; GKD olan bebeklerin %74,7’si kız ve %25,3’ü erkekti (P

Abstract

Purpose: To assess the sensitivity and specificity of clinical examination compared with ultrasonography (USG) in diagnosing developmental dysplasia of the hip (DDH). Methods: The files of children aged 6 months or younger who were born at the Başkent University Hospitals in the years 2000-2002 were examined. After examination of 443 infants by an experienced paediatrician, an orthopaedic surgeon evaluated all neonate hips by USG. The validity of the clinical examination results versus the validity of the USG examination results was assessed and analysed. Results: Of the 443 children, 55.8% were female and 44.2% were male; 74.7% of the infants having DDH were female and 25.3% were male (P < 0.05). Of the infants with DDH, 8.8% had a family history of the disorder. Analysis of the validity of the clinical examination results compared with USG examination results showed the sensitivity, specificity, (+) and (-) predictive values of clinical assessment to be 38.5%, 84.9%, 39.8%, and 84.2%, respectively. Conclusions: We recommend USG examinations for all infants at high risk for DDH because the examination is non-invasive, repeatable, inexpensive, and has no risk of ionizing radiation. Additionally, there is no need for sedation or contrast material administration.