Evaluation The Efficacy of Barlow and Ortalani Test in The Diagnosis of Developmental Dysplasia of The Hip in Infant in Salah Al-deen General Hospital

Abstract

This  cross sectional study aimed to assess the effectiveness of clinical examination using the Barlow and Ortolani tests compared to ultrasound diagnosis for identifying developmental dysplasia of the hip (DDH) in infants. The study involved 100 babies aged 1 week to 12 weeks, randomly selected from Salah Al-deen General Hospital between January and June 2020. The infants were examined using the Barlow and Ortolani tests, followed by ultrasound confirmation of DDH diagnosis.

Results showed that 9% of the infants had DDH. Infants with abnormal ultrasound findings had a higher birth weight, and significant associations were found with breech presentation, vaginal bleeding during pregnancy, and a family history of the same condition. Senior specialists were more accurate in diagnosing DDH compared to residents.

The sensitivity of the Barlow and Ortolani maneuvers was low for both residents and seniors, while specificities were high. Positive predictive values were better for residents, but negative predictive values were better for seniors. False-negative rates were lower for seniors, and false-positive rates were generally low.

In conclusion, clinical examination alone may not always accurately identify DDH in infants, as some babies with normal hips   may show abnormalities on ultrasound. Conversely, ultrasound scans may indicate clinical dysfunction in babies with normal hips. Female infants had a higher incidence of DDH, and certain risk factors were associated with the condition. The sensitivity of the Barlow and Ortolani tests was limited, but specificities were high, and the choice of examiner impacted predictive values