Neonatal Sonographic “Screening” for CDH: The Progress in Early Diagnosis & Treatment and the Prevention of Dysplasia & Secondary Osteoarthritis

Abstract

The effective prevention of late CDH has become a reality, since a diagnosis can be obtained early using the original sonographic method described by GRAF. A correct sonographic diagnosis must be followed by a consistent therapeutic management strategy and longterm follow-up. The results of a comparative follow-up study emphasize the enormous progress in the quality of therapeutic results gained by sonographic directly on maternity wards: A successful outcome by conservative treatment without femoral head necosis, without surgery and without late CDH is regularly obtained and costs less, if sonographic assessment is done within the first days of life! For these reasons, the Austrian government has included sonographic neonatal hip screening in its general health prevention program - and since 1992 also pays the costs of this preventive procedure. Hip sonography according to GRAF is 15 years old: The result of this learning curve is a strictly standardized reproduceable methodical system, which must be adhered to in order to get reproduceable results at the highest possible level of perfection (state of the art)! An educational system (l basic course of 36 hours of theory and practice, 200 babies under supervision, 1 final course of 12 hours and a colloquium are necessary to get the licence by the Austrian and German Health Services) has been operating for years, thus hip sonography and sonographic newborn hip-screening is widespread all over Austria and Germany. There are two main methodical aspects which are