Anouk F M van Gijzen1, Elsbeth D M Rouers2,3, Florens Q M P van Douveren4, Jeanne Dieleman5, Johannes G E Hendriks4, Feico J J Halbertsma6, Levinus A Bok6. 1. Department of Pediatrics and Neonatology, Máxima Medical Center, PO Box no. 7777, 5500, MB, Veldhoven, The Netherlands. afm.vangijzen@hotmail.com. 2. Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands. 3. Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands. 4. Department of Orthopedic Surgery, Orthopedie Groot Eindhoven, Eindhoven, The Netherlands. 5. Department of Epidemiology and Statistics, Máxima Medical Center, Veldhoven, The Netherlands. 6. Department of Pediatrics and Neonatology, Máxima Medical Center, PO Box no. 7777, 5500, MB, Veldhoven, The Netherlands.
Abstract
Guidelines for children with Down syndrome (DS) suggest to perform an annual hip screening to enable early detection of developmental dysplasia of the hip (DDH). How to perform this screening is not described. Delayed detection can result in disabling osteoarthritis of the hip. Therefore, we determined the association between clinical history, physical, and radiological examination in diagnosing DDH in children with DS. Referral centers for children with DS were interviewed to explore variety of hip examination throughout the Netherlands. Clinical features of 96 outclinic children were retrospectively collected. Clinical history was taken, physical examination was performed, and X-ray of the hip was analyzed. All the referral centers performed physical examination and clinical history; however, 20% performed X-ray. Following physical examination according to Galeazzi test 26.9% and to limited abduction 10.8% of the outclinic-studied children were at risk for DDH. Radiological examination showed moderate or severe abnormal deviating migration rate of 14.6% resp. 11.5% in the right and left hip. However, no association between clinical history, physical examination, and radiological examination was found. Conclusion: Clinical history and physical examination are insufficient to timely detect DDH in children with Down syndrome. Thereby regular radiological examination of the hip is advised. What is Known: • Developmental dysplasia of the hip (DDH) in people with Down syndrome (DS) develops during childhood. • Guidelines for medical support of children with DS suggest an annual hip screening to enable early detection of hip damaging. How to perform this annual screening is not described. What is New: • This study shows no association between clinical history, physical and radiological examination of the hip. • We recommend regular radiological examination of the hip in children with DS in order to identify DDH early up to 16 years of age.
Guidelines for children with Down syndrome (DS) suggest to perform an annual hip screening to enable early detection of developmental dysplasia of the hip (DDH). How to perform this screening is not described. Delayed detection can result in disabling osteoarthritis of the hip. Therefore, we determined the association between clinical history, physical, and radiological examination in diagnosing DDH in children with DS. Referral centers for children with DS were interviewed to explore variety of hip examination throughout the Netherlands. Clinical features of 96 outclinic children were retrospectively collected. Clinical history was taken, physical examination was performed, and X-ray of the hip was analyzed. All the referral centers performed physical examination and clinical history; however, 20% performed X-ray. Following physical examination according to Galeazzi test 26.9% and to limited abduction 10.8% of the outclinic-studied children were at risk for DDH. Radiological examination showed moderate or severe abnormal deviating migration rate of 14.6% resp. 11.5% in the right and left hip. However, no association between clinical history, physical examination, and radiological examination was found. Conclusion: Clinical history and physical examination are insufficient to timely detect DDH in children with Down syndrome. Thereby regular radiological examination of the hip is advised. What is Known: • Developmental dysplasia of the hip (DDH) in people with Down syndrome (DS) develops during childhood. • Guidelines for medical support of children with DS suggest an annual hip screening to enable early detection of hip damaging. How to perform this annual screening is not described. What is New: • This study shows no association between clinical history, physical and radiological examination of the hip. • We recommend regular radiological examination of the hip in children with DS in order to identify DDH early up to 16 years of age.
Entities:
Keywords:
Developmental dysplasia of the hip; Down syndrome; Multidisciplinary guidelines; Radiological examination
Authors: Lars Remvig; Raoul H Engelbert; Britta Berglund; Antonio Bulbena; Peter H Byers; Rodney Grahame; Birgit Juul-Kristensen; Karl-August Lindgren; Jouni Uitto; Lena L Wekre Journal: Rheumatology (Oxford) Date: 2011-04-10 Impact factor: 7.580
Authors: Frederike E C M Mulder; Levinus A Bok; Florens Q M P van Douveren; Hans E H Pruijs; Adelgunde V C M Zeegers Journal: J Child Orthop Date: 2021-10-01 Impact factor: 1.548