The expert group is proposing that the hip ultrasound scan should not be undertaken earlier than 3 weeks of age because it may not give a reliable result at an earlier age. There is currently no national guidance on the upper or lower limit for timing of hip ultrasound examination. What is your view of the proposal that all non-premature babies who are screen positive on newborn examination or who have risk factors should either be discharged or in the treatment pathway by the age of 6 weeks? Timing of hip ultrasound examination What is your view of the proposal that babies who are screen positive on newborn examination or who have risk factors should be treated the same in terms of the timing of their ultrasound examination?Ģb. Proposed new wordingĪll non-premature babies (screen positive and risk factor referrals) should have had an ultrasound scan and either be discharged or have entered the orthopaedic treatment pathway (seen by the specialist orthopaedic practitioner) by 6 weeks of age. Screen positive following 6 to 8 week infant examination infants should be referred directly to orthopaedic surgeon for urgent expert opinion and be seen by 10 weeks of age. Current national guidance wordingīabies who are found to have dislocated or dislocatable hips, positive Ortolani or Barlow manoeuvre on newborn physical examination (screen positive) should be referred and undergo hip ultrasound within 2 weeks of age.īabies who have risk factors but a normal newborn physical examination should be referred and undergo hip ultrasound within 6 weeks of age. The expert working group is proposing that there should be no differentiation in timeline for scan completion for babies requiring referral for ultrasound scan with screen positive findings or risk factors. What is your view on the proposal to reinforce national guidance for managing ‘clicky hips’ by removing reference to local management? Timing of hip ultrasound examination However, if the NIPE practitioner is unsure of their findings, the clinical examination should be repeated by an experienced clinician. This is based on evidence that there is no clinical benefit in undertaking hip ultrasound in these babies. Babies who have no national hip risk factors and are found to have ‘clicky hips’ on physical examination should not undergo hip ultrasound scan. Proposed new wordingĪ true ‘click’ in a hip that is stable on examination should not be treated as screen positive. Current national guidance wordingīabies who have no predisposing risk factors and are found to have ‘clicky hips’ on physical examination should be managed and referred as per local arrangement and should not be included in NIPE screening programme key performance indicator ( KPI) data. The expert working group is proposing the addition of clear national guidance regarding the management of babies found to have ‘clicky hips’ and no follow-up or referral for ultrasound scan for ‘clicky hips’.
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