Age-optimized cut-off values for pubofemoral distances in screening for hip dysplasia

TY - JOUR

T1 - Age-optimized cut-off values for pubofemoral distances in screening for hip dysplasia

AU - Husum, H. C.

AU - Hellfritzsch, M. B.

AU - Maimburg, R. D.

AU - Møller-Madsen, B.

AU - Henriksen, Mads

AU - Lapitskaya, N.

AU - Kold, S.

AU - Rahbek, O.

N1 - Publisher Copyright: © 2025 Husum et al.

PY - 2025

Y1 - 2025

N2 - Aims To establish cut-off values for lateral pubofemoral distance (PFD) measurements for detecting hip dysplasia in early (four days) and standard care (six weeks) screening for developmental dysplasia of the hip (DDH). Methods All newborns, during a one-year period (October 2021 to October 2022), were offered a PFD ultrasound (US) examination in addition to the existing screening programme for DDH. Newborns who were referred for standard care hip US, suspected for DDH, received a secondary PFD US examination in conjunction with the standard care Graf/Harcke hip US examination. Receiver operating characteristic curves and empirically optimal cut-off values were calculated with a true positive defined as a Graf type ≥ IIc hip. Results We included 2,735 newborns, of whom 758 received both early PFD hip US and standard care Graf/Harcke hip US. For early (four days) PFD screening, the optimal cut-off point was calculated to be 6.2 mm (95% CI 4.7 to 7.7) producing a sensitivity of 80% (95% CI 55% to 100%) and a specificity of 87% (86% to 89%). For PFD screening performed at standard care (six weeks) hip US, the optimal cut-off point was calculated to be 5.6 mm (95% CI 4.9 to 6.3) producing a sensitivity of 100% (95% CI 100% to 100%) and a specificity of 96% (95% CI 95% to 97%). Conclusion PFD US screening produces a high degree of both sensitivity and specificity for detecting DDH. Age-specific cut-off values should be used to heighten the accuracy of PFD US screening.

AB - Aims To establish cut-off values for lateral pubofemoral distance (PFD) measurements for detecting hip dysplasia in early (four days) and standard care (six weeks) screening for developmental dysplasia of the hip (DDH). Methods All newborns, during a one-year period (October 2021 to October 2022), were offered a PFD ultrasound (US) examination in addition to the existing screening programme for DDH. Newborns who were referred for standard care hip US, suspected for DDH, received a secondary PFD US examination in conjunction with the standard care Graf/Harcke hip US examination. Receiver operating characteristic curves and empirically optimal cut-off values were calculated with a true positive defined as a Graf type ≥ IIc hip. Results We included 2,735 newborns, of whom 758 received both early PFD hip US and standard care Graf/Harcke hip US. For early (four days) PFD screening, the optimal cut-off point was calculated to be 6.2 mm (95% CI 4.7 to 7.7) producing a sensitivity of 80% (95% CI 55% to 100%) and a specificity of 87% (86% to 89%). For PFD screening performed at standard care (six weeks) hip US, the optimal cut-off point was calculated to be 5.6 mm (95% CI 4.9 to 6.3) producing a sensitivity of 100% (95% CI 100% to 100%) and a specificity of 96% (95% CI 95% to 97%). Conclusion PFD US screening produces a high degree of both sensitivity and specificity for detecting DDH. Age-specific cut-off values should be used to heighten the accuracy of PFD US screening.

KW - clubfeet

KW - Developmental dysplasia of the hip

KW - developmental dysplasia of the hip (DDH)

KW - femoral head

KW - hip joint

KW - hips

KW - intraclass correlation coefficient (ICC)

KW - Mass screening

KW - musculoskeletal radiologists

KW - orthopaedic surgeons

KW - Paediatrics

KW - retrospective analysis

KW - sensitivity analysis

KW - Ultrasound

UR - https://www.scopus.com/pages/publications/85217647282

U2 - 10.1302/2633-1462.62.BJO-2024-0181.R1

DO - 10.1302/2633-1462.62.BJO-2024-0181.R1

M3 - Journal article

C2 - 39894046

AN - SCOPUS:85217647282

SN - 2633-1462

VL - 6

SP - 119

EP - 125

JO - Bone and Joint Open

JF - Bone and Joint Open

IS - 2

ER -