What are the recommended screening methods for detecting developmental dysplasia of the hip (DDH) in newborns?

Recommended screening methods for detecting developmental dysplasia of the hip (DDH) in newborns primarily involve a combination of clinical examination and selective use of ultrasound imaging.

Initial screening is performed through a thorough clinical examination of all newborns, focusing on specific manoeuvres such as the Barlow and Ortolani tests to detect hip instability or dislocation NICE NG72. This clinical assessment is recommended universally as the first-line screening method in the UK.

For newborns identified as having risk factors (such as family history of DDH, breech presentation, or clinical suspicion of hip instability), targeted ultrasound screening is advised to improve early detection rates NICE NG72. Ultrasound is the preferred imaging modality because it allows visualization of the cartilaginous structures of the infant hip, which are not visible on X-ray at this age Duarte et al. 2022.

Routine universal ultrasound screening of all newborns is not currently recommended in UK guidelines due to cost-effectiveness and resource considerations, but recent meta-analyses suggest that universal ultrasound screening may reduce late detection rates of DDH compared to selective screening strategies Kuitunen et al. 2022Shorter et al. 2011.

In summary, the UK clinical practice endorses universal clinical examination at birth with selective ultrasound screening for at-risk infants, while recent literature highlights potential benefits of broader ultrasound screening approaches that may inform future guideline updates NICE NG72; Kuitunen et al. 2022Duarte et al. 2022Shorter et al. 2011.