The Significance of Isolated Hip Click as a Sign of DDH: Implications on Referral Guidelines

医学 髋关节发育不良 骨科手术 介绍(产科) 发育不良 前瞻性队列研究 人口 超声波 外科 放射科 射线照相术 内科学 环境卫生
作者
William Z. Morris,Laura M. Mayfield,Henry B. Ellis,Corey S. Gill,Daniel J. Sucato,David A. Podeszwa,Chan-Hee Jo,Harry K.W. Kim
出处
期刊:Journal of Pediatric Orthopaedics [Lippincott Williams & Wilkins]
卷期号:43 (6): e411-e415 被引量:3
标识
DOI:10.1097/bpo.0000000000002404
摘要

Background: The clinical significance of an isolated hip click remains unclear. The rates of developmental dysplasia of the hip (DDH) in those referred for hip click vary from 0% to 28%. The purpose of this study was to evaluate the rate of DDH in patients prospectively referred for isolated hip click. Methods: We prospectively enrolled patients referred to a single pediatric orthopaedic center with concern for DDH secondary to isolated hip click felt by the pediatrician on examination. Patients with known sonographic abnormalities or risk factors for DDH (breech presentation or positive family history) were excluded. Ultrasounds were obtained upon initial presentation and defined as abnormal if alpha angle <60 degrees and/or femoral head coverage (FHC) <50%. Mild dysplasia, analogous to Graf IIa physiological immaturity, was defined as alpha angle 50<α<60 and/or <50% FHC in a patient <3 months age. Severe dysplasia was defined as ≤33% FHC, which has been proposed to be sonographically consistent with a hip dislocation. Results: Two hundred fifty-five children were referred for isolated hip click. One hundred eighty-nine patients (74%) had normal ultrasound whereas 66 patients (26%) had sonographic abnormalities (mean age 6.5±6.2 wk at initial ultrasound). Fifty patients (19.6%) demonstrated physiological immaturity, 3 patients (1.2%) demonstrated moderate sonographic dysplasia, and 13 patients (5.1%) had sonographic findings consistent with severe dysplasia or dislocated hip. Hips with severe dysplasia were younger than the remaining population (2.8±2.4 wk vs. 6.6±6.2 wk, P <0.001) with no difference in sex distribution ( P =0.07) or first-born birth order ( P =0.36). For those with sonographic abnormality, 18 (27%) patients were treated with Pavlik harness, 1 (2%) was treated with abduction orthosis, and the remainder (71%) were observed for resolution of physiological immaturity. Conclusions: Infants with isolated hip click identified by their pediatrician may have higher rates of dysplasia than previously reported. We recommend screening ultrasound and/or orthopaedic referral for all infants with isolated hip click. Level of Evidence: Level II—prospective prognostic study.
最长约 10秒,即可获得该文献文件

科研通智能强力驱动
Strongly Powered by AbleSci AI
更新
PDF的下载单位、IP信息已删除 (2025-6-4)

科研通是完全免费的文献互助平台,具备全网最快的应助速度,最高的求助完成率。 对每一个文献求助,科研通都将尽心尽力,给求助人一个满意的交代。
实时播报
平凡完成签到,获得积分10
2秒前
3秒前
哈利波特完成签到,获得积分10
6秒前
菓小柒完成签到 ,获得积分10
6秒前
basil完成签到,获得积分10
7秒前
大橙子发布了新的文献求助10
7秒前
mammer应助超帅无色采纳,获得10
8秒前
helloworld完成签到,获得积分10
9秒前
海洋完成签到,获得积分10
9秒前
Hina完成签到,获得积分10
10秒前
ZH完成签到,获得积分10
13秒前
yyds完成签到,获得积分10
14秒前
量子星尘发布了新的文献求助10
16秒前
17秒前
唯梦完成签到 ,获得积分10
17秒前
詹姆斯哈登完成签到,获得积分10
20秒前
李健应助名字不好起采纳,获得10
22秒前
万历完成签到,获得积分10
22秒前
22秒前
林卷卷完成签到,获得积分10
23秒前
大葱鸭发布了新的文献求助10
25秒前
26秒前
李健应助南山无梅落采纳,获得10
26秒前
30秒前
赘婿应助大橙子采纳,获得10
32秒前
39秒前
我是大学霸完成签到,获得积分10
40秒前
随风完成签到,获得积分0
40秒前
yi完成签到 ,获得积分10
41秒前
lin完成签到,获得积分10
42秒前
huahua完成签到 ,获得积分10
42秒前
大橙子发布了新的文献求助10
45秒前
小黑完成签到,获得积分10
48秒前
ZY完成签到 ,获得积分10
51秒前
阿士大夫完成签到,获得积分0
51秒前
chai完成签到,获得积分10
51秒前
GUO完成签到,获得积分10
52秒前
111完成签到 ,获得积分10
53秒前
Llllll发布了新的文献求助200
54秒前
天下无马完成签到 ,获得积分10
55秒前
高分求助中
【提示信息,请勿应助】关于scihub 10000
Les Mantodea de Guyane: Insecta, Polyneoptera [The Mantids of French Guiana] 3000
徐淮辽南地区新元古代叠层石及生物地层 3000
The Mother of All Tableaux: Order, Equivalence, and Geometry in the Large-scale Structure of Optimality Theory 3000
Handbook of Industrial Diamonds.Vol2 1100
Global Eyelash Assessment scale (GEA) 1000
Picture Books with Same-sex Parented Families: Unintentional Censorship 550
热门求助领域 (近24小时)
化学 材料科学 医学 生物 工程类 有机化学 生物化学 物理 内科学 纳米技术 计算机科学 化学工程 复合材料 遗传学 基因 物理化学 催化作用 冶金 细胞生物学 免疫学
热门帖子
关注 科研通微信公众号,转发送积分 4038157
求助须知:如何正确求助?哪些是违规求助? 3575869
关于积分的说明 11373842
捐赠科研通 3305650
什么是DOI,文献DOI怎么找? 1819255
邀请新用户注册赠送积分活动 892655
科研通“疑难数据库(出版商)”最低求助积分说明 815022