• 1 week ago

When Should Newborns Be Screened for Hip Dysplasia?

What Is Developmental Dysplasia of the Hip (DDH)?

DDH refers to a range of abnormalities where the hip joint is underdeveloped, unstable, or completely dislocated. It involves a mismatch between the femoral head (thigh bone) and the acetabulum (hip socket).

DDH occurs in approximately 1–3 out of every 1,000 newborns, and is more common in girls.

Why Is Early Diagnosis Important?

  • If left untreated, DDH can cause walking difficulties, joint pain, and the need for hip replacement in early adulthood.
  • Diagnosed in the first 6 months, it can usually be treated without surgery.
  • Late diagnosis often requires invasive procedures.

When Is Hip Dysplasia Screening Done?

1. Physical Examination – Within the First 24 Hours

  • The initial check is done by a pediatrician soon after birth.
  • Ortolani and Barlow maneuvers are used to detect hip looseness or dislocation.

2. Hip Ultrasound – Between Weeks 4 and 6

  • Ideal timing: At 4–6 weeks of age
  • Doing it earlier (within first 3 weeks) may result in false positives due to natural looseness in newborn hips.

Hip ultrasound is safe, painless, and radiation-free.

Who Should Get a Hip Ultrasound?

In many countries, including Türkiye, universal screening is recommended. However, certain babies are at higher risk and require closer monitoring:

High-Risk Groups:

  • Female infants
  • First-born babies
  • Family history of DDH
  • Breech presentation during pregnancy
  • Low amniotic fluid (oligohydramnios)
  • Accompanying conditions like torticollis or clubfoot

These babies may need earlier and more frequent evaluations.

How Is the Hip Ultrasound Performed?

  • The baby is placed on their back, and a specialized ultrasound probe is used on each hip.
  • The Graf method is commonly used to assess hip development and angle measurements.
  • The procedure takes only a few minutes and causes no discomfort.

Interpreting the Results and Follow-Up

Result

Interpretation

Follow-Up

Type 1 (Normal)

Proper hip joint formation

No further action needed

Type 2a (Immature hip)

Mild delay in development

Repeat ultrasound in 2–4 weeks

Type 2b or higher (Dysplasia or dislocation)

Intervention required

Orthopedic referral, Pavlik harness if needed

Treatment Options

1. Pavlik Harness

  • Most common method in the first 6 months
  • Holds the baby’s hips in a specific position to help proper joint alignment

2. Surgery

  • Needed in late-diagnosed cases
  • May include closed or open reduction techniques depending on severity

Tips for Parents

  • Avoid tight swaddling that restricts hip movement
  • Dress baby in a way that allows free leg motion
  • Use hip-healthy diapers or carriers
  • Attend all scheduled follow-ups, especially for high-risk babies