Correspondence (letter to the editor): The Value of Hip Ultrasound Screening

I was surprised to read in Deutsches Ärzteblatt—which published the fact first that general hip ultrasound screening is obligatory in Germany until now by law—that “at present, the question whether introducing general ultrasound hip screening for neonates could bring an improvement (…) is still under debate” (1).

As early as 2008, Ihme et al. showed that ultrasound screening is superior to mere clinical screening. The incidence rate of surgical measures was lowered by our hip ultrasound screening from 1.26/1000 liveborn infants who were merely clinically screened to 0.26/1000 infants.

In addition to the cited Vienna based working group of Thallinger, Thaler et al. showed in 2011 that in Austria, after Graf general ultrasound screening had been introduced in the first and sixth to eights week of life, the need for surgical interventions in children aged 0–15 years was reduced by 75.9% compared with general clinical screening including the Barlow and Ortolani test (3). Furthermore, as a result of ultrasound-guided therapy, treatment costs fell from 410 000 ####€ per year to 117 000 ####€/year, while screening costs rose by only 57 000 ####€/year.

Admittedly, the articles by Thaler et al. and Thallinger et al. had not been published at the time of the Cochrane analysis. But the available study by Ihme et al. was not considered either.

In conclusion, the cited Cochrane review at best allows conclusions about the outcome of hip ultrasound screening methods in general. The Cochrane review is based on publications in which the ultrasound examinations were done according to Elbourne, Graf, Harcke, Terjessen or in a modified Graf-Technique (4).