To evaluate decision-making processes OF pediatricians regarding developmental dysplasia of the hip (DDH) diagnosis and management by conducting a survey of pediatricians in the US.
An electronic survey was sent to multiple AAP state chapters and academic pediatrics groups, and responses were received from pediatricians in 10 states. The survey included demographics, guideline use, clinical scenarios, and referrals/imaging practices. The number of responses to each survey question and their relative frequencies were calculated.
We received 139 responses and included 126 in analyses. Only 50% of pediatricians (63/126) practice in an institution that endorses a care pathway for DDH. 5.6% of pediatricians (7/125) have referred patients between 12-18 months to a specialist for suspected DDH, and 9.5% (12/125) have referred patients between 6-9 months. 23% of pediatricians (29/126) cited “hip click” as an abnormality that would prompt them to refer a patient to a specialist. Only 72.2% of pediatricians (91/126) indicated that family history of DDH warrants an ultrasound regardless of examination findings. Several surveyed pediatricians (10.3%, 13/126) are only “somewhat” or “moderately” familiar with Barlow and Ortolani maneuvers.
The results of this study indicate that there is an opportunity to better distribute and implement DDH guidelines. The large number of pediatrician respondents who would not refer patients to a specialist or order imaging studies appropriately represents an opportunity for education. The implementation of a care map with standard referral and imaging practices could improve the care of patients with DDH.

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