Screening Infants for Developmental Dysplasia of the Hip

Infants are screened for many illness, diseases, and conditions at birth. About one per cent of the newborns have a condition called developmental dysplasia of the hip (DDH). Babies with DDH are much more likely to have another condition called congenital muscular torticollis (CMT).

With DDH there is a disruption in the normal relationship between the head of the femur (thigh bone) and the acetabulum (hip socket). The hip may be partially dislocated or completely dislocated. A partial dislocation is called subluxation.

CMT or wry neck means twisted neck. One of the neck muscles (the sternocleidomastoid muscle or SCM) is in a contracted state. Constant contraction of the SCM tilts the head to one side. The chin rotates or turns to the opposite side.

In this study, pediatric orthopedic surgeons reviewed the medical charts of children with DDH or CMT. If the child was diagnosed with DDH in the first month of life, there was a nine per cent risk of also developing CMT. They found that girls were more likely to have DDH. Boys with DDH were five times more likely to have both DDH and CMT. The authors suggest this link may be due to problems during the birth, genetics, or hormonal factors.

The authors conclude that children with CMT should also be screened for DDH. Ultrasound is the best tool for screening DDH in children up to six months of age. X-rays are used after that. Infants with DDH (especially boys) should be watched for any signs of CMT developing.