The underlying challenges facing selective screening for dysplasia of the hip

Clinical hip examinations are at the centre of all selective screening programmes for DDH, but the positive predictive value of clinical hip examinations performed by primary screeners is low. In this study we try to explain the underlying challenges facing selective screening for DDH.

In this original research article titled: Self-reported knowledge of national guidelines for clinical screening for hip dysplasia: a web-based survey of midwives and general practitioners in Denmark, we examined the self-reported recognition of nationally recommended clinical hip examinations in the screening programme for DDH in Denmark among midwives, general practitioners (GPs) and GPs in training.

We asked the respondents to identify which of six written statements of clinical hip examinations were featured in the national Danish guidelines on DDH screening. Three statements were the official statements of the Ortolani, Galeazzi and hip abduction examinations and three statements were false and constructed by the author group.

We found a high level of recognition for the Ortolani manoeuvre (89%) but significantly lower levels of recognition for the Galeazzi and hip abduction examinations (<58%), which the majority of respondents were unable to distinguish from constructed false statements.

These findings underline the problems facing decentralized DDH screening and the need for continuous educational efforts to be made in clinical screening for DDH if this method of screening is to be pursued in the future.

Find the article online here (Open Access): https://bjgpopen.org/content/early/2021/06/11/BJGPO.2021.0068.long