{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,21]],"date-time":"2025-08-21T17:46:37Z","timestamp":1755798397099,"version":"3.44.0"},"reference-count":20,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2025,2,14]],"date-time":"2025-02-14T00:00:00Z","timestamp":1739491200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["ANZ Journal of Surgery"],"published-print":{"date-parts":[[2025,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Explore the differences in ultrasound reporting between community ultrasound centres and a high\u2010volume paediatric tertiary centre in diagnosing developmental dysplasia of the hip (DDH).<\/jats:p><\/jats:sec><jats:sec><jats:title>Participants<\/jats:title><jats:p>One hundred infants less than 6\u2009months of age from a paediatric hip registry, who underwent ultrasounds in both community and tertiary centres within a 2\u2010week interval.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>One percent of a 200\u2010hip sample reported scan quality. Alpha angles were reported in 84.5% (<jats:italic>n<\/jats:italic>\u2009=\u2009169) of community reports and 78.5% (<jats:italic>n<\/jats:italic>\u2009=\u2009157) of tertiary centre reports. Femoral head coverage was reported similarly in both environments at 94.5% in community and 93.5% in tertiary. Beta angle appeared in 45% (<jats:italic>n<\/jats:italic>\u2009=\u200990) and 2% (<jats:italic>n<\/jats:italic>\u2009=\u20094), respectively. Bland Altman plots revealed that there existed variation in ultrasound interpretation especially in more dysplastic hips. The concordance correlation coefficient showed only moderate agreement (Rho\u2009=\u20090.60 for alpha angles, Rho\u2009=\u20090.61 for femoral head coverage), and interrater reliability on hip classification reached moderate agreement (Cohen's Kappa\u2009=\u20090.57 for alpha angle, and 0.45 for femoral coverage) between community and tertiary hospital reports.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Reliance on the community\u2010acquired ultrasound report as a true reflection of the state of a hip is not completely justified. The lack of standardized reporting poses challenges for community clinicians in starting treatment or making appropriate referrals. Only a moderate agreement has been observed between the community and tertiary scans. Consequently, over 25% of hips classified as abnormal are potentially normal, and more than 15% dysplastic hips could be undetected.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ans.70000","type":"journal-article","created":{"date-parts":[[2025,2,14]],"date-time":"2025-02-14T08:05:13Z","timestamp":1739520313000},"page":"557-563","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Ultrasound for hip dysplasia \u2013 disparities between community and tertiary paediatric services"],"prefix":"10.1111","volume":"95","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-5674-2383","authenticated-orcid":false,"given":"Ye","family":"Zhu","sequence":"first","affiliation":[{"name":"Royal Melbourne Hospital Murdoch Children's Research Institute  Flemington Road Parkville Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Melody","family":"Feng","sequence":"additional","affiliation":[{"name":"Murdoch 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