Resumo

SILVA, Carlos  e  COSTA, Gilberto. Importância da ecografia no rastreio e diagnóstico precoce da displasia do desenvolvimento da anca. Rev. Port. Ortop. Traum. [online]. 2013, vol.21, n.2, pp.147-163. ISSN 1646-2122.

Aim: Early diagnosis of Developmental Dysplasia of the Hip (DDH) is essential to initiate appropriate treatment and improve the long-term outcomes. We sought to gather and synthesize the more recent published evidence regarding the utility of ultrasonography in the screening and early diagnosis of DDH. Sources of data: The MEDLINE database was searched for articles published on the use of ultrasonography in DDH, over the last 11 years, with MeSH terms “congenital hip dislocation” and “ultrasonography”. The reference lists of all trials and reviews selected were manually searched for further articles. A total of 89 articles (randomized controlled trials, clinical trials, practice guidelines, meta-analysis and systematic reviews) were included in this review. Summary of data: The benefits and harms of newborn ultrasound screening for DDH are not clearly understood. The optimal screening method and its effectiveness still need to be established although it seems essential that screening tests are performed by trained and competent examiners. Several observational studies demonstrate that both selective and universal ultrasound screening reduce the number of late DDH and the need for surgery. Conclusions: Screening with clinical examination or ultrasonography can identify newborns at increased risk for DDH, but because the high rate of spontaneous resolution of neonatal hip instability and dysplasia and the lack of evidence of the effectiveness of intervention on functional outcomes, the net benefits of screening are not clear. There is a need for high quality studies and randomized trials to assess the effectiveness and safety of neonatal screening and early treatment.

Palavras-chave : Orthopedics; hip; developmental dysplasia of the hip; congenital hip dislocation; ultrasonography; screening; diagnosis.

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