title: The Occurrence of Occult Acetabular Dysplasia in Relatives of Individuals With Developmental Dysplasia of the Hip.
abstract: BACKGROUND
  This study sought to determine the hip pathology of family members of patients with developmental dysplasia of the hip (DDH). The authors evaluated 120 people from 19 families known to have at least 1 member with surgically treated DDH. Each individual's functional outcome scores and pelvic radiographs were assessed for hip symptoms or pathology.
  
  
  METHODS
  Using a genetic population database and a pediatric hospital patient population, 19 families with high rates of DDH were identified. All family members (n=120) underwent physical examination, radiographic assessment, and completion of outcome instruments [American Academy of Orthopedics (AAOS) Hip and Knee; Harris Hip Score (HHS); and Western Ontario and McMaster Universities Arthritis Index (WOMAC)].
  
  
  RESULTS
  The 120 subjects ranged from 1 to 84 years, 34 had orthopaedically treated DDH. Of the remaining 86 supposedly normal subjects, 23 (27%) had occult acetabular dysplasia (OAD) as defined by center edge angle (CEA) <20 and/or a Severin score of III or greater. Sixty percent of the 86 individuals were less than 30 years old, 74% of the OAD group were less than 30. Outcome scores of the treated DDH patients (AAOS, HHS, and WOMAC) were worse on the involved side regardless of age. Over age 30 individuals with OAD had statistically significant decreases in their AAOS Hip and Knee and WOMAC scores on the dysplastic side, but their HHS scores were not significantly different.
  
  
  CONCLUSIONS
  Twenty-seven percent of first-degree and second-degree relatives of patients with DDH had unsuspected radiographic acetabular dysplasia in our study. Most of the subjects with OAD were younger than 30. After age 30, many of these patients developed symptoms.
  
  
  CONCLUSIONS
  In families with a significant history of DDH, radiographic screening of siblings of patients with DDH to define OAD may be prudent.
  
  
  METHODS
  Level I—diagnostic study.
authors.affiliation: *Salt Lake City Shriners Hospitals for Children ‡Division of Medical Genetics §ARUP Laboratories, Department of Pathology, University of Utah, Salt Lake City, UT †Gillette Children's Specialty Healthcare, Saint Paul, MN ∥Children's Hospital of Pittsburgh, University of Pittsburgh, Pittsburgh, PA.
authors.forename: Kristen L
authors.initials: KL
authors.lastname: Carroll
authors.forename: Alison N
authors.initials: AN
authors.lastname: Schiffern
authors.forename: Kathleen A
authors.initials: KA
authors.lastname: Murray
authors.forename: David A
authors.initials: DA
authors.lastname: Stevenson
authors.forename: David H
authors.initials: DH
authors.lastname: Viskochil
authors.forename: Reha
authors.initials: R
authors.lastname: Toydemir
authors.forename: Bruce A
authors.initials: BA
authors.lastname: MacWilliams
authors.forename: James W
authors.initials: JW
authors.lastname: Roach
mesh_terms: D000077:Acetabulum / Q000002:abnormalities* / Q000000981:diagnostic imaging; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D005190:Family; D005260:Female; D020022:Genetic Predisposition to Disease; D006618:Hip Dislocation, Congenital / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000235:genetics; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D008875:Middle Aged; D011859:Radiography; D012189:Retrospective Studies; D014481:United States / Q000453:epidemiology; D055815:Young Adult