{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T06:58:27Z","timestamp":1792047507886,"version":"4.4.0"},"reference-count":32,"publisher":"Royal College of General Practitioners","issue":"693","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Br J Gen Pract"],"published-print":{"date-parts":[[2020,4]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>The current 6- to 8-week Newborn and Infant Physical Examination (NIPE) clinical assessment is a current standard hip-screening test in the community (England) to detect developmental dysplasia of the hip (DDH).<\/jats:p><\/jats:sec><jats:sec><jats:title>Aim<\/jats:title><jats:p>To assess the value of the primary care 6- to 8-week clinical hip examination for the diagnosis of DDH.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design and setting<\/jats:title><jats:p>A single-centre 15-year observational cohort study at a district general hospital between 1 January 1996 and 31 December 2010.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>Those referred by the GP or community practitioner with suspected instability or abnormality of the hip joint (DDH), were clinically and sonographically examined in a specialist hip-screening clinic. Modified Graf Type III and IV, and radiological irreducible hip dislocation were considered to be \u2018pathological\u2019 hips. Screening failures were defined as those who had not been identified by this primary care screening assessment (but had irreducible hip dislocation). Secondary univariate and multivariable analyses were performed to determine which clinical findings are predictive of instability.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Over the study period, there were 70 071 infants who underwent the 6- to 8-week clinical hip assessment. In the specialist hip-screening clinic, six (from the 170 referred) were diagnosed with pathological DDH. The sensitivity, specificity, positive predictive value, and negative predictive value for the 6- to 8-week clinical hip assessment were 16.7%, 99.8%, 3.5%, and 100.0%, respectively. A multivariable model showed a positive Ortolani manoeuvre to be the sole independent predictor of instability at 6 to 8 weeks.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This 15-year study highlights the limitations of a hip check at 6 to 8 weeks. These findings support the reassessment of the national guidelines for this aspect of the NIPE DDH screening programme.<\/jats:p><\/jats:sec>","DOI":"10.3399\/bjgp20x708269","type":"journal-article","created":{"date-parts":[[2020,2,25]],"date-time":"2020-02-25T05:29:25Z","timestamp":1582608565000},"page":"e230-e235","source":"Crossref","is-referenced-by-count":16,"title":["Evaluation of primary care 6- to 8-week hip check for diagnosis of developmental dysplasia of the hip: a 15-year observational cohort study"],"prefix":"10.3399","volume":"70","author":[{"given":"Ronnie","family":"Davies","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher","family":"Talbot","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robin","family":"Paton","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1987","published-online":{"date-parts":[[2020,2,24]]},"reference":[{"key":"2020081209344869000_70.693.e230.1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.105.4.896"},{"key":"2020081209344869000_70.693.e230.2","doi-asserted-by":"publisher","DOI":"10.1053\/adnc.2003.50016"},{"issue":"5","key":"2020081209344869000_70.693.e230.3","doi-asserted-by":"crossref","first-page":"704","DOI":"10.1302\/0301-620X.74B5.1527117","article-title":"Radiographic screening at four months of infants at risk for congenital hip dislocation","volume":"74","author":"Garvey","year":"1992","journal-title":"J Bone Joint Surg Br"},{"key":"2020081209344869000_70.693.e230.4","doi-asserted-by":"publisher","DOI":"10.1136\/adc.61.9.921"},{"key":"2020081209344869000_70.693.e230.5","unstructured":"Public Health England Newborn and infant physical examination (NIPE) screening programme handbook 2019 https:\/\/www.gov.uk\/government\/publications\/newborn-and-infant-physical-examination-programme-handbook\/newborn-and-infant-physical-examination-screening-programme-handbook#examination-of-the-hips (accessed 12 Feb 2020)."},{"key":"2020081209344869000_70.693.e230.6","unstructured":"Public Health England Our approach to newborn and infant physical examination screening standards 2018 https:\/\/www.gov.uk\/government\/publications\/newborn-and-infant-physical-examination-screening-standards\/our-approach-to-newborn-and-infant-physical-examination-screening-standards (accessed 4 Feb 2020)."},{"key":"2020081209344869000_70.693.e230.7","doi-asserted-by":"publisher","DOI":"10.1097\/00003086-197507000-00015"},{"issue":"5","key":"2020081209344869000_70.693.e230.8","doi-asserted-by":"crossref","first-page":"290","DOI":"10.1016\/j.surge.2017.05.002","article-title":"Screening in Developmental Dysplasia of the Hip (DDH)","volume":"15","author":"Paton","year":"2017","journal-title":"Surgeon"},{"key":"2020081209344869000_70.693.e230.9","unstructured":"American Academy of Orthopedic Surgeons Detection and nonoperative management of pediatric developmental dysplasia of the hip in infants up to six months of age Evidence-based clinical practice guideline 2014 https:\/\/www.aaos.org\/research\/guidelines\/DDHGuidelineFINAL.pdf (accessed 21 Jan 2020)."},{"key":"2020081209344869000_70.693.e230.10","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2005-1597"},{"key":"2020081209344869000_70.693.e230.11","doi-asserted-by":"publisher","DOI":"10.1002\/ebch.1891"},{"key":"2020081209344869000_70.693.e230.12","unstructured":"Paton RW Does selective ultrasound imaging of \u2018at risk\u2019 hip and clinically unstable hips, in developmental dysplasia of the hip (DDH) produce an effective screening programme 2011 University of Lancaster PhD Thesis, EThOS ID: uk.bl.ethos.618306."},{"key":"2020081209344869000_70.693.e230.13","first-page":"804","article-title":"Early diagnosis and treatment of congenital dislocation of the hip","volume":"56","author":"Barlow","year":"1963","journal-title":"Proc R Soc Med"},{"key":"2020081209344869000_70.693.e230.14","first-page":"129","article-title":"A little sign and its relevant importance in the early diagnosis of congenital dislocation of the hip. 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