Screening for Developmental Dysplasia of the Hip: Recommendation Statement

Abstract

The US Preventive Services Task Force (USPSTF) concludes that evidence is insufficient to recommend routine screening for developmental dysplasia of the hip (DDH) in infants as a means to prevent adverse outcomes (I recommendation).* The pathophysiology and natural history of DDH are poorly understood. There is evidence that screening leads to earlier identification; however, 60% to 80% of the hips of newborns identified as abnormal or as suspicious for DDH by physical examination and >90% of those identified by ultrasound in the newborn period resolve spontaneously and require no intervention. There is poor evidence (poor-quality studies) of the effectiveness of both surgical and nonsurgical interventions; avascular necrosis of the hip (AVN) is reported in 0% to 60% of children who are treated for DDH. Thus, the USPSTF was unable to assess the balance of benefits and harms of screening for DDH but was concerned about the potential harms associated with treatment of infants identified by routine screening. Address correspondence to Ned Calonge, MD, MPH, US Preventive Services Task Force, c/o Program Director, USPSTF, Agency for Healthcare Research and Quality, 540 Gaither Rd, Rockville, MD 20850. E-mail: uspstf{at}ahrq.gov