Ultrasound-enhanced physical examination reliable for diagnosis of hip dysplasia
NEW ORLEANS — Ultrasound-enhanced physical examination of the hip may be a reliable method for the diagnosis of hip dysplasia in infants, according to results presented at the AAP National Conference & Exhibition.
An experienced clinician performed a 2-hour one-on-one training session on ultrasound-enhanced physical examination of the hip with three different providers, including a pediatric orthopedic fellowship-trained surgeon with 4 years of experience, a fifth-year orthopedic surgery resident and a pediatrician with 3 years of experience. Pablo Castaneda, MD, and colleagues had all four examiners independently perform examinations on 227 infants to determine if the infants had normal, dysplastic, unstable or dislocated hips. To determine agreement amongst the examiners, a fifth examiner who was familiar with the technique analyzed the results.
“With a simple 2-hour one-on-one session for training, we were able to reliably show that the different providers produced the same results,” Castaneda, division chief of pediatric orthopedic surgery at Hassenfeld Children’s Hospital at NYU Langone, told Healio.com/Orthopedics.
When breaking the findings into binary results of normal vs. abnormal, Castaneda noted an agreement of 97% for the examiners.
“This allows us to have this technology, which is cheap [and] accessible, ... there are no side effects doing it, and it proves the diagnostic accuracy,” Castaneda said.
Unaware of how simple and accessible ultrasound enhanced physical examination of the hip can be, the medical community has been surprised with the results of this study, Castaneda said. However, he noted the study was limited and follow-up studies are needed.
“The next step is to prove that this can be replicable across different levels of training, different geographic locations and different cultures,” Castaneda said. – by Casey Tingle
Castaneda P, et al. A prospective study to assess the clinical impact of interobserver reliability of ultrasound enhanced physical examination of the hip. Presented at: AAP National Conference & Exhibition; Oct. 25-29, 2019; New Orleans.
Disclosure: Castaneda reports no relevant financial disclosures.