Limited evidence supports that the practitioner perform serial physical examinations and periodic imaging assessments (ultrasound or radiograph based on age) during management for unstable infant hips.

If brace treatment is initiated, there is limited evidence that episodic serial physical and imaging reassessments during the treatment cycle can lead to changes or duration of the treatment plan. Two low strength studies report monitoring of brace treatment using physical exam, ultrasound, and radiography following the appearance of the ossific nucleus.31, 32 Both studies identified failure of reduction or persistent dysplasia in patients undergoing brace treatment. These findings necessitated a change in treatment plan or duration. No parameters for optimal timing or frequency of imaging were established by research protocol.

Risks and Harms:
Radiographs involve exposure to ionizing radiation.
  1. (31) Cashman JP, Round J, Taylor G, Clarke NM. The natural history of developmental dysplasia of the hip after early supervised treatment in the Pavlik harness. A prospective, longitudinal follow-up. J Bone Joint Surg Br 2002;84(3):418-425.
  2. (32) Swaroop VT, Mubarak SJ. Difficult-to-treat Ortolani-positive hip: improved success with new treatment protocol. J Pediatr Orthop 2009;29(3):224-230.