Stable Hip with Ultrasound Imaging Abnormalities
Limited evidence supports observation without a brace for infants with a clinically stable hip with morphologic ultrasound imaging abnormalities.
For an infant with a normal physical examination and ultrasound abnormalities, there is limited evidence to support observation without treatment of that infant with serial ultrasound evaluation up to 6 weeks of age. One low-strength study evaluated a group of at-risk patients who were evaluated by ultrasound between two and six weeks of age with clinically stable hips showing ultrasonographic abnormalities that were randomized to treatment with Pavlik harness or observation.23The two primary outcome measures were the acetabular coverage on ultrasound and acetabular index on radiograph. While acetabular coverage, measured ultrasonographically, improved in both groups, and was statistically better in the splinted group at the final, three month follow-up, there was no difference in acetabular index.
Risks and Harms
The risk of implementing this recommendation is that necessary treatment could be delayed.