An absolute indication of X-ray of the pelvis in case of congenital dislocation of the hip are all except –
Correct Answer: Shortening of limb
Description: Screening for DDH/CDH
The method of screening and the choice of the population to be screened are controversial. Three methods of DDH screening have been described.
Clinical screening via universal physical examination during the first year of life by properly trained medical providers. Follow-up ultrasounds for abnormal or questionable examinations can be considered.
Universal clinical (physical examination) screening with additional selective ultrasound or radiographic screening for children with risk factors. This risk factors proposed include female gender, breech presentation at delivery, positive family history, and some data suggest torticollis and congenital foot deformity as well. The practitioner must remember that the majority of children with DDH have no identifiable risk factors; thus, this method of screening cannot be expected to detect all cases of DDH. Ultrasound or radiographic examination is an adjunct, not a replacement, of clinical examination.
Universal screening of all babies with ultrasound or radiography in addition to a physical examination. This practice would be expensive and would require significant additional resources. The benefit of universal screening has not been demonstrated, and the practice would increase the identification of "abnormalities" that would resolve without intervention.
Because female infants with a positive family history of DDH and females born in the breech presentation have the highest risk of DDH, imaging with an ultrasound or radiography is recommended for these infants.
Category:
Orthopaedics
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