In infants, is the universal ultrasound screening more useful than the selective one to detect the developmental dysplasia of the hip?

Authors’ conclusion: none of the ultrasound strategies have shown to improve clinical outcomes, including late diagnosis of developmental dysplasia of the hip and surgery, as the studies are substantially underpowered to detect significant differences in these uncommon events.

Reviewers’ commentary: due to the low incidence of developmental dysplasia of the hip and its consequences (surgery, avascular necrosis of the femoral head, osteoarthritis ...), currently there are not studies with sufficient size and methodological quality to answer the question. Recent studies of low methodological quality report the benefit of universal screening to reduce the need for surgery, but do not rule out the possibility that this measure could increase the need for treatments that in many cases are unnecessary (mild dysplasia resolves spontaneously between 6 weeks and 6 months in >90% of untreated hips) and not without complications .