ACR Appropriateness Criteria® Developmental Dysplasia of the Hip-Child
Document Type
Article
Publication Date
5-2019
Identifier
DOI: 10.1016/j.jacr.2019.02.014
Abstract
Developmental dysplasia of the hip (DDH) is the most common hip pathology in infants. Although its exact pathophysiology remains incompletely understood, its long-term prognosis depends not only on the severity of the dysphasia, but also on the timely implementation of appropriate treatment. Unrecognized and untreated hip subluxations and dislocations inevitably lead to early joint degeneration while overtreatment can produce iatrogenic complications, including avascular necrosis of the femoral head. In the past two decades, imaging has become an integral part of the clinical screening, diagnosis, and monitoring of children with DDH. Optimal timing for imaging and appropriate use of imaging can reduce the incidence of late diagnoses and prevent iatrogenic complications. In general, ultrasound of the hips is recommended in infants under the age of 4 months while pelvic radiography is recommended in older infants due to the fact that the femoral head ossific nucleus typically is not formed until 4 to 6 months of age. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment.
Journal Title
J Am Coll Radiol
Volume
16
Issue
5S
First Page
94
Last Page
103
MeSH Keywords
Contrast Media; Diagnosis, Differential; Evidence-Based Medicine; Hip Dislocation, Congenital; Humans; Infant; Infant, Newborn; Societies, Medical; United States
Keywords
AUC; Appropriate Use Criteria; Appropriateness Criteria; Children; DDH; Hip; Imaging; Screening; Ultrasound
Recommended Citation
Expert Panel on Pediatric Imaging:, Nguyen JC, Dorfman SR, et al. ACR Appropriateness Criteria® Developmental Dysplasia of the Hip-Child. J Am Coll Radiol. 2019;16(5S):S94-S103. doi:10.1016/j.jacr.2019.02.014
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