ArticleJournal of pediatric orthopedics2020
Even Experts Can Be Fooled: Reliability of Clinical Examination for Diagnosing Hip Dislocations in Newborns.
Article in Journal of pediatric orthopedics, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers.
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Who cites it
20 citing papers in PubMed, 43 citations in OpenAlex.
- Association of objective structured clinical examination performance on nurse-led hip ultrasound imaging success: A prospective cohort study.International journal of nursing studies advances · 2026Article
- Applications of Artificial Intelligence in Pediatric Orthopaedics.Indian journal of orthopaedics · 2026Review
- Early Screening for Developmental Dysplasia of the Hip: Sonographic Reference Values, Risk Factors, and Treatment Considerations.International journal of neonatal screening · 2025Article
- Integrating web-based and objective structured clinical examination training programs for nurses on ultrasound hip screening during neonatal and infant home visits: a case study.BMC medical education · 2025Article
- Application of real-time shear wave elastography technology in healthy pediatric hip joints.BMC medical imaging · 2025Article
- Developmental Dysplasia of the Hip: Factors Related to the Diagnosis and Characteristics of Selective Screening for its Detection.Indian journal of orthopaedics · 2025Article
- Radiographic criteria in developmental dysplasia of the hip in late infancy, inter and intrareader agreement.PloS one · 2025Article
- Universal ultrasound screening and early treatment of developmental dysplasia of the hip: a critical review.Journal of medicine and life · 2024Review
- Evaluation of Serum and Urine Biomarker Panels for Developmental Dysplasia of the Hip Prior to Onset of Secondary Osteoarthritis.Cartilage · 2024Article
- Who performs neonatal hip assessment: is there a cause for concern?BMJ paediatrics open · 2024Observational
- Developing an Educational Program for Ultrasound Hip Screening during Newborn and Infant Home Visits: A Protocol Paper.Nursing reports (Pavia, Italy) · 2024Article
- Developmental Dysplasia of the Hip - Part 1.Revista brasileira de ortopedia · 2023Article
- Community-Based Hip Screening for Up to Four-Month-Old Infants and Health Guidance for Their Caregivers in Japan: A Nation-Wide Survey.Nursing reports (Pavia, Italy) · 2023Article
- Remote diagnostic imaging using artificial intelligence for diagnosing hip dysplasia in infants: Results from a mixed-methods feasibility pilot study.Paediatrics & child health · 2023Article
- Causes of late-presenting developmental dislocation of the hip beyond 12 months of age: A pilot study.The Indian journal of medical research · 2023Article
- Progress in screening strategies for neonatal developmental dysplasia of the hip.Frontiers in surgery · 2022Review
- Screening of Newborns and Infants for Developmental Dysplasia of the Hip: A Systematic Review.Indian journal of orthopaedics · 2021Review
- Effects of developmental dysplasia of the hip screening program on the treatment strategies: A retrospective study from a tertiary care hospital in the southeast region of Turkey.Acta orthopaedica et traumatologica turcica · 2021Article
- Cost Analysis of Screening Programmes for Developmental Dysplasia of the Hip: A Systematic Review.Indian journal of orthopaedics · 2020Review
- A Semi-automatic Diagnosis of Hip Dysplasia on X-Ray Films.Frontiers in molecular biosciences · 2020Article
Corrections and comments
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Authors and funding
9 authors at 5 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe aim of this study was to assess the accuracy of clinical screening examination in newborns with dislocated hips compared with ultrasound scan (USS).
methodsNewborns, up to 3 months of age, with confirmed hip dislocations on USS were prospectively enrolled in a multinational observational study. Data from 2010 to 2016 were reviewed to determine pretreatment clinical examination findings of the treating orthopaedic surgeon as well as baseline ultrasound indices of developmental dysplasia of the hip (DDH). All infants had been referred to specialist centres with expertise in DDH, due to abnormal birth examination or risk factor.
resultsThe median age of the study population was 2.3 weeks and 84% of patients were female. Of the total 515 USS-confirmed dislocated hips included in the study, 71 (13.8%) were incorrectly felt to be reduced on clinical examination by the treating orthopaedist (P<0.001). Full hip abduction was documented in 106 hips. Of the hips correctly identified as dislocated, 322 hips were further analyzed based on clinical reducibility. Thirty-three of 322 (10.2%) were incorrectly thought to be reducible when in fact they were irreducible or vice versa.
conclusionsExpert examiners missed a significant number of frankly dislocated hips on clinical examination and their ability to classify hips based on clinical reducibility was only moderately accurate. This study provides evidence that, even in experienced hands, physical examination findings in DDH are often too subtle to elicit clinically in the first few months of life. This may explain the persistent and measurable rate of late presenting dislocations in countries with screening programmes reliant on clinical examination. LEVEL OF EVIDENCE: Level 1-testing of previously developed diagnostic criteria in series of consecutive patients (with universally applied reference "gold" standard).
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