Hip dysplasia or dislocation in infancy is a condition that has long been recognized. Fortunately, it affects only a small number of children; however, in those who do develop it, it can lead to a serious condition.
Several risk factors may play a role in its development, such as gender, gestational age at birth, or whether the parents had hip abnormalities at birth.
Early detection can prevent the need for more invasive and uncomfortable treatments, which is why hip screening became mandatory in Hungary decades ago. This simple and painless examination can reliably detect hip dysplasia.
According to the screening protocol in Hungary, musculoskeletal screenings for infants are conducted at 3–4 days, 4–6 weeks, and 3–4 months of age.
The first hip examination of infants is performed by a neonatologist in the hospital’s neonatal unit. If the baby was in a breech position or there is a family history of hip dislocation, the screening must be repeated at certain intervals. To detect any hidden hip development abnormalities, the infant must be taken for a hip screening at an orthopedic clinic at one month of age, even if no hip abnormalities were found during the newborn examination.
The screening should be performed at an orthopedic clinic when the infant is 4–6 weeks old. The screening itself consists of two parts that complement each other well. During the physical examination, we check hip mobility with a few simple movements, while the recommended ultrasound examination provides a more accurate picture of the hip joint’s development. Routine ultrasound is necessary because in half of all cases of hip dysplasia, no risk factors are present, and the physical examination reveals no abnormalities. For newborns and infants who have any risk factors for hip dislocation, an ultrasound examination must be performed to rule out hip dysplasia. An ultrasound examination is also warranted if, immediately after birth, the neonatologist detects a loose, unstable hip and this condition does not resolve within 2–3 weeks.
Legal Framework
Decree No. 51/1997 (December 18) of the Ministry of Health on health services for the prevention and early detection of diseases available under the compulsory health insurance system and on the certification of screening examinations