If faced with a child who has a normal physical examination, there is limited evidence that performing subsequent hip physical examination screening of children up to 6 months of age will detect additional children with DDH. The reviewed literature does not include the screening of children up to walking age when other examination findings such as gait abnormalities may allow for detection of additional children with DDH. One low strength study presented evidence that repeated studies at three months were productive in identifying late diagnosed DDH. 22 Another low strength study noted that exams at eight months of age had a high rate of false positives, but no yield of true positives.21
There is no literature to define the optimal frequency or duration of follow-up surveillance.
Risks and Harms
There is a potential risk of over diagnosis and treatment.
Limited evidence supports that a practitioner re-examine infants previously screened as having a normal hip examination on subsequent visits prior to 6 months of age.
American Academy of Orthopaedic Surgeons Detection and Nonoperative Management of Pediatric Developmental Dysplasia of the Hip in Infants up to Six Months of Age. https://www.aaos.org/globalassets/quality-and-practice-resources/pddh/pediatric-developmental-dysplasia-hip-clinical-practice-guideline-4-23-19.pdf Published September 5, 2014.