Use of Limited Hip Abduction as a Predictor for Developmental Dysplasia of the Hip

Abstract

Background: Developmental dysplasia of the hip (DDH) includes multiple abnormalities. Females are more susceptible for DDH. The clinical examination is used for diagnosis, but its sensitivity is generally low. Ultrasound (US) examination identifies DDH in infants younger than 6 months of age. Because of its accessibility and the lack of exposure to radiation, the clinical applications of US in the diagnosis of DDH have expanded, making it the gold standard test for DDH. Objective: This study aimed to measure sensitivity and specificity of limited hip abduction (LHA) as a screening test for the detection of DDH. Materials and Methods: A cross-sectional study including 60 infants were brought to the Al-Wasity Teaching Hospital, Baghdad and Al-Rusafa Health Directorate, Ministry of Health and Environment, Baghdad, Iraq, within the period from January 2020 to October 2020. They were referred by other physicians and clinics or their parents suspected that they have abnormal hip. We excluded infants with associated congenital abnormality such as arthrogryposis or spina bifida. The diagnosis was made by clinical and US examination. The clinical examination included identification of LHA. Data regarding age and gender were recorded and were statistically analyzed. Frequencies and means were used to express data, and the χ2 goodness of fit test and Student’s t-test were used as appropriate to detect significance of difference between frequencies and means. Results: The sensitivity and specificity of unilateral and bilateral LHA were 51.35%, 95.18% and 27.03%, 63.86%, respectively. Conclusion: Unilateral LHA was more sensitive and specific than bilateral.