title: The most relevant diagnostic criteria for developmental dysplasia of the hip: a study of British specialists.
abstract: BACKGROUND
  Developmental dysplasia of the hip (DDH) is the most common orthopaedic disorder in newborns. Despite this considerable variation in practice exists. The aim of this study was to determine the clinical relevance and a ranking order for the diagnostic criteria in DDH amongst paediatric orthopaedic surgeons practicing in the UK.
  
  
  METHODS
  One hundred members of the British Society of Children's Orthopaedic Surgery (BSCOS) were asked to rate the importance of 37 criteria useful in the diagnosis of DDH in newborns, using a 10 cm visual analogue scale. We determined the consistency among specialists in rating the criteria with the intraclass correlation coefficient (ICC) and compared the results to a group of international peers.
  
  
  RESULTS
  Ortolani/Barlow tests, asymmetry in abduction ≥20° and a first-degree relative treated for DDH ranked among the top ten. Participants demonstrated poor consistency in rating the 37 criteria (ICC 0.39; 95% CI 0.29, 0.52), but for clinical examination criteria alone their consistency improved (ICC 0.52; 0.35, 0.75). The importance ratings of members of BSCOS and members of the European Paediatric Orthopaedic Society differed for 15/37 (41%) criteria (p <0.05).
  
  
  CONCLUSIONS
  Members of BSCOS had a preference for criteria relating to clinical examination and ultrasound.
authors.affiliation: Department of Orthopaedic Surgery, Great Ormond Street Hospital for Children, Great Ormond Street, London, WC1N 3JH, UK. williams-dan@hotmail.co.uk.
authors.forename: Daniel
authors.initials: D
authors.lastname: Williams
authors.affiliation: Institute of Child Health, University College, London, UK. e.protopapa@ucl.ac.uk.
authors.forename: Evangelia
authors.initials: E
authors.lastname: Protopapa
authors.affiliation: Addenbrooke's Hospital, Cambridge, UK. kkbhangal@doctors.org.uk.
authors.forename: Kuldeep
authors.initials: K
authors.lastname: Stohr
authors.affiliation: Nottingham University Hospital, Nottingham, UK. Annjameshunter@aol.com.
authors.forename: James B
authors.initials: JB
authors.lastname: Hunter
authors.affiliation: Department of Orthopaedic Surgery, Great Ormond Street Hospital for Children, Great Ormond Street, London, WC1N 3JH, UK. a.roposch@ucl.ac.uk.|Institute of Child Health, University College, London, UK. a.roposch@ucl.ac.uk.
authors.forename: Andreas
authors.initials: A
authors.lastname: Roposch
mesh_terms: D005260:Female; D005500:Follow-Up Studies; D006618:Hip Dislocation, Congenital / Q000175:diagnosis* / Q000453:epidemiology; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D008511:Medicine / Q000379:methods; D010372:Pediatrics / Q000379:methods*; D010808:Physical Examination / Q000379:methods*; D012955:Societies, Medical; D013038:Specialization; D006113:United Kingdom / Q000453:epidemiology