Researchers conducted a survey of doctors in the United States to assess pediatricians’ decision-making processes regarding the diagnosis and therapy of developmental dysplasia of the hip (DDH).
An internet survey was distributed to numerous American Academy of Pediatrics state chapters and academic pediatrics groups, and pediatricians from ten states responded. Demographics, guideline utilization, clinical situations, and referral/imaging procedures were all included in the study. The total number of replies to each survey question and their relative frequency was computed.
They got 139 replies and analyzed 126 of them. Only half of the responding pediatricians (63 of 126) worked in a facility that supports a DDH care route. Only 5.6% of pediatricians (7 of 125) sent kids to a specialist for suspected DDH between 12 and 18 months, while 9.5% (12 of 125) referred patients between 6 and 9 months. Almost one-quarter of the pediatricians (23%; 29 of 126) mentioned “hip click” as an anomaly that would induce them to refer a patient to a specialist, and 72.2% (91 of 126) said that a family history of DDH merits an ultrasound regardless of physical examination findings. Furthermore, 10.3% of the pediatricians polled (13 of 126) said they were only “slightly” or “moderately” familiar with the Barlow and Ortolani techniques.
The study’s findings suggested that there is a potential to improve the distribution and implementation of DDH recommendations. The huge proportion of pediatrician responders who would not send patients to a specialist or request adequate imaging procedures is an educational opportunity. Implementing a care map with uniform referral and imaging methods may enhance the management of DDH patients.
Reference: jpeds.com/article/S0022-3476(22)00168-8/fulltext
