title: Screening for the coexistence of congenital muscular torticollis and developmental dysplasia of hip.
abstract: OBJECTIVE
  To investigate the coexistence rate and related factors of developmental dysplasia of the hip (DDH) and congenital muscular torticollis (CMT), and to determine whether ultrasonography (US) gives good value for screening of DDH in CMT.
  
  
  METHODS
  We prospectively examined 121 infants (73 males and 48 females) diagnosed with CMT to determine the incidence of DDH by US. We also assessed the relationship between neck US findings and DDH occurrence, and investigated the clinical features of CMT related to DDH.
  
  
  RESULTS
  18 patients (14.9%) were diagnosed as having DDH by US. However, most DDH was subclinical and spontaneously resolved. Only 2 patients (1.7%) needed to be treated with a harness. The positive predictive value of clinical examinations for DDH was 52.6% and patients treated by harness were all clinically positive. DDH was more common in the left side (13 left, 4 right, 1 both), but 6 out of 18 DDH (33.3%) cases presented on the contralateral side of CMT. Sex difference was not observed. Breech presentation and oligohydramnios were not related to DDH occurrence. Neck US findings did not correlate with DDH occurrence.
  
  
  CONCLUSIONS
  The coexistence rate of CMT and DDH was concluded to be 14.9%. If only DDH cases that required treatment were included, the coexistence rate of these two disorders would be lowered to 1.7%. All of these patients showed positive findings in clinical examination. Therefore, hip US should not be recommended routinely for patients with CMT.
authors.affiliation: Department of Rehabilitation Medicine, Pusan National University School of Medicine, Busan 602-739, Korea.
authors.forename: Sung Nyun
authors.initials: SN
authors.lastname: Kim
authors.forename: Yong Beom
authors.initials: YB
authors.lastname: Shin
authors.forename: Wan
authors.initials: W
authors.lastname: Kim
authors.forename: Hwi
authors.initials: H
authors.lastname: Suh
authors.forename: Han Kyeong
authors.initials: HK
authors.lastname: Son
authors.forename: Young Sun
authors.initials: YS
authors.lastname: Cha
authors.forename: Jae Hyeok
authors.initials: JH
authors.lastname: Chang
authors.forename: Hyun-Yoon
authors.initials: HY
authors.lastname: Ko
authors.forename: In Sook
authors.initials: IS
authors.lastname: Lee
authors.forename: Min Jeong
authors.initials: MJ
authors.lastname: Kim