{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,10]],"date-time":"2025-12-10T14:38:52Z","timestamp":1765377532795,"version":"3.46.0"},"reference-count":21,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2025,12,10]],"date-time":"2025-12-10T00:00:00Z","timestamp":1765324800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medical Sciences"],"abstract":"<jats:p>Background: Developmental dysplasia of the hip (DDH) encompasses a spectrum of neonatal hip abnormalities that, if not detected and treated early, may lead to long-term orthopedic sequelae. Universal ultrasound screening using Graf\u2019s method has been proposed to improve early diagnosis, though its implementation remains heterogeneous in Italy. Objectives: This study aimed to describe the outcomes of a universal ultrasound screening program for DDH conducted in a first-level birth center in northern Italy, evaluating DDH incidence, risk factors, management outcomes, and program feasibility. Methods: A prospective observational study was conducted from February 2024 to October 2025 at the Ivrea birth center (Piedmont region, Italy). All consecutive live-born infants (n = 904) underwent hip ultrasound according to Graf\u2019s method, between 0 and 11 weeks of age. Hips were classified as type I (normal), type IIa (physiologically immature), or type IIb\u2013IV (pathological). Infants with type IIa hips were re-evaluated after 2\u20134 weeks; those with type IIb or worse were referred to pediatric orthopedics. Results: Of 1808 hips examined, 92% were Graf type I and 8% type IIa. After follow-up, 93% of type IIa hips matured spontaneously. Pathological DDH (Graf IIb or worse) was diagnosed in 8 infants (0.88%), of whom 75% were female; 50% had no identifiable risk factors. All affected infants were treated with harness before 12 weeks of age, with complete recovery and no late diagnoses. No infant required surgical treatment. Conclusions: Universal ultrasound screening for DDH was feasible and effective in a first-level birth center, ensuring early diagnosis and absence of late-presenting cases. These findings support universal screening as a safe and equitable approach to reduce DDH-related morbidity and align with national recommendations for standardized early detection programs.<\/jats:p>","DOI":"10.3390\/medsci13040311","type":"journal-article","created":{"date-parts":[[2025,12,10]],"date-time":"2025-12-10T14:22:40Z","timestamp":1765376560000},"page":"311","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Universal Hip Ultrasound Screening in Newborns: A 21-Month Prospective Observational Study in a Spoke Center"],"prefix":"10.3390","volume":"13","author":[{"given":"Neftj","family":"Ragusa","sequence":"first","affiliation":[{"name":"Pediatrics and Neonatology Department, Ivrea Hospital, Piazza Credenza 2, ASLTO4, Piedmont, 10015 Ivrea, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nefer Roberta","family":"Gianotto","sequence":"additional","affiliation":[{"name":"Pediatrics and Neonatology Department, Ivrea Hospital, Piazza Credenza 2, ASLTO4, Piedmont, 10015 Ivrea, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Virginia","family":"Deut","sequence":"additional","affiliation":[{"name":"Pediatrics and Neonatology Department, Ivrea Hospital, Piazza Credenza 2, ASLTO4, Piedmont, 10015 Ivrea, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chiara","family":"Mattivi","sequence":"additional","affiliation":[{"name":"Pediatrics and Neonatology Department, Ivrea Hospital, Piazza Credenza 2, ASLTO4, Piedmont, 10015 Ivrea, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0208-9534","authenticated-orcid":false,"given":"Francesca","family":"Compagno","sequence":"additional","affiliation":[{"name":"Pediatrics and Neonatology Department, Ivrea Hospital, Piazza Credenza 2, ASLTO4, Piedmont, 10015 Ivrea, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marta","family":"Cherubini Scarafoni","sequence":"additional","affiliation":[{"name":"Pediatrics and Neonatology Department, Ivrea Hospital, Piazza Credenza 2, ASLTO4, Piedmont, 10015 Ivrea, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Silvia","family":"Dominici","sequence":"additional","affiliation":[{"name":"Pediatrics and Neonatology Department, Ivrea Hospital, Piazza Credenza 2, ASLTO4, Piedmont, 10015 Ivrea, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3455-3802","authenticated-orcid":false,"given":"Massimo","family":"Berger","sequence":"additional","affiliation":[{"name":"Pediatrics and Neonatology Department, Ivrea Hospital, Piazza Credenza 2, ASLTO4, Piedmont, 10015 Ivrea, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,12,10]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"e557","DOI":"10.1542\/peds.2005-1597","article-title":"Screening for developmental dysplasia of the hip: A systematic literature review for the US Preventive Services Task Force","volume":"117","author":"Shipman","year":"2006","journal-title":"Pediatrics"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1541","DOI":"10.1016\/S0140-6736(07)60710-7","article-title":"Developmental dysplasia of the hip","volume":"369","author":"Dezateux","year":"2007","journal-title":"Lancet"},{"key":"ref_3","first-page":"478","article-title":"Diagnosis of congenital hip dysplasia","volume":"22","author":"Atti","year":"1996","journal-title":"IJP"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"150","DOI":"10.1186\/s13052-020-00908-2","article-title":"Recommendations for early diagnosis of Developmental Dysplasia of the Hip (DDH): Working group intersociety consensus document","volume":"46","author":"Agostiniani","year":"2020","journal-title":"Ital. 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