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The incidence of DDH varies from 1.5 to 20 per 1,000 births, depending on the criteria used for diagnosis and the population studied ( 1). In this way, the radiologist can aid in preventing serious disability of the hip.
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Set aside the uncertainties about whom and when to screen, it needs to be emphasized that ultrasound screening for developmental dysplasia of the hip is important, since the disease is initially occult and easier to treat when identified early. Is it better to perform sonography in all newborn infants like in Germany and Austria? Or should we examine only the infants with clinical hip instability or risk factors (breech position, positive family history), like in the UK and the Netherlands? This article reviews the epidemiology, static and dynamic ultrasound techniques in screening for developmental dysplasia of the hip, and differences in screening programs throughout Europe.
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The use of universal versus selective ultrasound remains a controversy, as does the timing. There is no consensus on the best way to screen for developmental dysplasia of the hip, which is probably the reason why different screening programs exist throughout Europe, as will be discussed in this article. Furthermore, the process of dynamic ultrasound imaging will be explained as well as the use of transinguinal ultrasound in infants wearing a spica cast. The Graf method is the most widely used ultrasound technique for infant hips a stepwise approach will be shown in this article. Besides physical examination, ultrasound is the preferred imaging modality for screening for developmental dysplasia of the hip in children aged younger than six months. Developmental dysplasia of the hip comprises a broad spectrum of abnormalities in hip development, of variable severity.