Correspondence (letter to the editor): Pathological Entities Were Mixed Together

The section on hip dysplasia and hip dislocation in the article by Yagdiran et al (1) contains problematic information that cannot be left uncommented. First of all, the two pathological entities intertwined in this section—congenital hip dysplasia and neurogenic hip dislocation—are of secondary importance in an article about hip pain in children because in children, these conditions usually manifest without pain. This necessitates complex surveillance programs that in congenital hip dysplasia means compulsory sonography in infants, with subsequent milestone radiography; in neurogenic hip dislocation it means follow-up by applying risk stratification according to the German hip surveillance program “Hüftampel”.

Furthermore, it is not beneficial to mix together these two pathological entities, since they are clearly diametrically different in terms of etiopathogenesis, age at manifestation, and therapy (2, 3).

What is particularly problematic is citing the 2013 review by Shorter et al (reference 29) as regards the question of the validity of hip screening in neonates, which used evidence from 2009 and is therefore out of date—which should have been discussed in the context of the present article. A more recent current concept review was presented by Biedermann and Eastwood (4), which contains all relevant information on the topic and does not leave readers in any doubt about the value of neonatal hip ultrasound. This investigation is laborious to carry out in routine clinical practice, but it saves the children interminable suffering and takes the burden off pediatric orthopedic operating theatres, which, ultimately, should be what we should all aim for.