title: Diagnosing Developmental Dysplasia of Hip in Newborns Using Clinical Screen and Ultrasound of Hips-An Indian Experience.
abstract: OBJECTIVE
  To study the cost-effectiveness of clinical screen with ultrasonography (USG) of hip for diagnosing developmental dysplasia of the hip (DDH) in newborns.
  
  
  METHODS
  Retrospective study (2006-14). Term newborns had (i) target scan at 6 weeks-family history of DDH or breech presentation-and (ii) early scan-abnormal clinical screen.
  
  
  RESULTS
  In all, 736 babies had USG scan. Five early scans (Graf's classification; three Type IIA, one Type IIC and one Type IIIB] and 15 target scans (Type IIA) were reported abnormal. All Type IIA DDH had subsequent 12 weeks' scans normal. Babies with Type IIIB and IIC had hip reduction surgery at 6 and 16 months of age, respectively. At cost 200 INR/scan, total 147 200 INR was incurred against two possible hip replacements prevented.
  
  
  CONCLUSIONS
  Universal clinical screen with USG of hip can aid in early diagnosis of DDH in newborns. Large population-based studies from developing countries need to look in its cost-effectiveness.
authors.affiliation: Department of Neonatology, Cloudnine Hospital, Banglore 560011, India drkishore@cloudninecare.com.
authors.forename: Rajagopal
authors.initials: R
authors.lastname: Kishore Kumar
authors.affiliation: Department of Neonatology, Cloudnine Hospital, Mumbai 400064, India.
authors.forename: Piyush
authors.initials: P
authors.lastname: Shah
authors.affiliation: Department of Neonatology, Cloudnine Hospital, Banglore 560011, India.
authors.forename: Ramya
authors.initials: R
authors.lastname: An
authors.affiliation: Department of Neonatology, Cloudnine Hospital, Banglore 560011, India.
authors.forename: Ramani
authors.initials: R
authors.lastname: Rajan
mesh_terms: D003362:Cost-Benefit Analysis; D006618:Hip Dislocation, Congenital / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control; D006801:Humans; D007194:India; D007223:Infant; D007231:Infant, Newborn; D007235:Infant, Premature, Diseases / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy; D008297:Male; D015997:Neonatal Screening / Q000191:economics / Q000379:methods*; D012189:Retrospective Studies; D014463:Ultrasonography
keywords: DDH; clinical screen; target USG