We have published a review of universal ultrasound screening for developmental dysplasia of the hip in infants in Ireland.
Speaking about the findings of the report Dr Máirín Ryan, our Deputy CEO and Director of Health Technology Assessment said: “We found that the evidence relating to the effectiveness of universal compared to selected ultrasound screening for developmental dysplasia of the (DDH) was too limited to allow us to make a clear conclusion on the added value of universal screening. As a result, there is a lot of uncertainty around whether or not introducing a universal ultrasound screening would be beneficial.”
As requested by the National Screening Advisory Committee (NSAC), we examined the evidence on the effectiveness of universal ultrasound screening (which involves screening every infant) compared with selective ultrasound screening (which involves screening only some infants, based on risk factors) for DDH.
DDH is a congenital disease where the ‘ball and socket’ joint of the hip does not properly form in babies and young children. DDH can affect one or both hips, and is more common in girls, firstborn children and babies born in the breech position. In mild cases, the symptoms (for example, pain) may resolve without treatment. However, for those with more severe DDH, early intervention is needed, as DDH can result in long-term pain, early osteoarthritis of the hip and back, and the need for hip replacements.
In Ireland, there is no universal screening programme in place; instead, infants who are at greater risk of DDH may be selected for ultrasound examination.
In 2017, recommendations were published for a selective ultrasound screening programme for DDH in Ireland. The recommendations can be read in the implementation pack here. It is unclear the extent to which these recommendations have been applied across hospitals in Ireland. It is possible that a better understanding of current practice for the identification of DDH in infants would help with future implementation of the 2017 recommendations; this would be with a view to a formal screening programme with appropriate oversight, end-to-end care, quality assurance, and monitoring of outcomes.