To study the cost-effectiveness of clinical screening with ultrasonography (USG) of hip for diagnosing developmental dysplasia of the hip (DDH) in new borns

ABSTRACT

Aim: To study the cost-effectiveness of clinical screen with ultrasonography (USG) of hip for diagnosing developmental dysplasia of the hip (DDH) in new borns. Methodology: Prospective study was conducted in DVVPF's Medical College and Hospital, Ahmednagar over a period of two years. Term new borns had (i) target scan at 6 weeks—family history of DDH or breech presentation—and (ii) early scan—abnormal clinical screen. Results: In all, 58 babies had USG scan. Five early scans (Graf's classification; three Type IIA, one Type IIC and one Type IIIB] and 15 target scans (Type IIA) were reported abnormal. All Type IIADDH had subsequent 12 weeks' scans normal. Babies with Type IIIB and IIC had hip reduction surgery at 6 and 16 months of age, respectively. At cost Rs. 200 INR/- scan, total Rs. 1,47,200/- INR was incurred against two possible hip replacements prevented. Conclusion: Universal clinical screen with USG of hip can aid in early diagnosis of DDH in newborns. Large population-based studies from developing countries need to look in its cost-effectiveness.