Developmental dysplasia of the hip and occult neurologic disorders.
Developmental dysplasia of the hip (DDH) is a neonatal condition with various causes. Neuromuscular dysplasia of the hip (NDH) is a sequel of neuromuscular disease, and generally presents later in childhood than DDH. Some evidence, however, supports a concept of a neuromuscular etiology of DDH: (1) a high prevalence of spinal dysraphism in DDH; and (2) abnormal sensory evoked potentials in 31% of DDH patients. To explore this suggestion we ascertained the presence of neuromuscular disease within a cohort of DDH patients, and asked whether the neuromuscular condition is the initial etiology of the dysplasia or a coincidental finding. We retrospectively reviewed patients presenting with DDH. Only those with an initial diagnosis of DDH and a subsequent diagnosis of a neuromuscular condition were assessed. Fifteen of 560 patients fulfilled the criteria, however the presence of true DDH within this group was minimal, as several cases emerged as early presenting NDH. We therefore believe it unlikely DDH has a substantial neurological etiology.


METHODS
Level III, prognostic study. See the Guidelines for Authors for a complete description of levels of evidence.
Luther
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AZ
MP 817, Southampton General Hospital, University of Southampton, Tremona Road, Southampton, SO16 6YD, UK.
Clarke
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NM
D000077:Acetabulum / Q000000981:diagnostic imaging; D000375:Aging; D001175:Arthrography; D018450:Disease Progression; D005260:Female; D006618:Hip Dislocation, Congenital / Q000000981:diagnostic imaging / Q000209:etiology* / Q000503:physiopathology / Q000628:therapy; D006621:Hip Joint / Q000000981:diagnostic imaging / Q000503:physiopathology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009468:Neuromuscular Diseases / Q000150:complications* / Q000000981:diagnostic imaging; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index