Validity of diagnostic methods in detection of congenital hip luxation in primary care

• Published in: Atención primaria Vol. 14; no. 5; p. 775
• Main Authors: Sánchez Ruiz-Cabello, F J, García Aparicio, J M, Bellón Saameño, J A, Ariza Sánchez, I
• Format: Journal Article
• Language: Spanish
• Published: Spain 30.09.1994
• Subjects: Age Factors; Child, Preschool; Cross-Sectional Studies; Follow-Up Studies; Hip Dislocation, Congenital - diagnosis; Hip Dislocation, Congenital - diagnostic imaging; Hip Dislocation, Congenital - epidemiology; Humans; Infant; Infant, Newborn; Primary Health Care; Prospective Studies; Radiography; Spain - epidemiology; Time Factors
• ISSN: 0212-6567

To find the validity of the clinical and radiological methods used within Primary Care in the early diagnosis of Congenital Hip Luxation (CHL). A prospective observation study. Zaidín-Sur Basic Health Area (HA), Granada. An urban Health Centre. All new-born and nursing babies born in our HA between October 1991 and March 1993 (N = 352), followed and studied over an average period of 22.4 months (SD = 5.6) (Range, 12 to 30 months). The prevalence of clinically and/or radiologically-based suspected CHL was 19% (Cl 95%; 12.7-25.3%) and the prevalence of confirmed CHL was 4.2% (Cl 95%; 1.96-6.44%). Ortolani-Barlow sensitivity (O-B) was 46.7%, specificity 85.2%; positive predictive value 12.3%, negative predictive value 97.6%, false positives 14.8% and false negatives 53.3%. When positive O-B and/or other positive clinical signs were taken into consideration, sensitivity rose to 73.3% and false negatives went down to 26.7%. If we had not performed radiologies systematically on all the nursing children, we would have missed CHL diagnosis in 1.14% of our basic HA's population-group. We question the clinical diagnosis of CHL due to its low sensitivity and an excessive number of false negatives. We recommended systematic testing by means of a diagnostic image method, which could be X-Rays at 3 to 5 months.