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KMID : 0361420110350040485
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Journal of Korean Academy of Rehabilitation Medicine
2011 Volume.35 No. 4 p.485 ~ p.490
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Screening for the Coexistence of Congenital Muscular Torticollis and Developmental Dysplasia of Hip
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Kim Sung-Nyun
Shin Yong-Beom
Kim Wan
Suh Hwi
Son Han-Kyeong
Cha Young-Sun
Chang Jae-Hyeok
Ko Hyun-Yoon
Lee In-Sook
Kim Min-Jeong
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Abstract
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Objective: To investigate the coexistence rate and related factors of developmental dysplasia of the hip (DDH) and congenital muscular torticollis (CMT), and to determine whether ultrasonography (US) gives good value for screening of DDH in CMT.
Method: We prospectively examined 121 infants (73 males and 48 females) diagnosed with CMT to determine the incidence of DDH by US. We also assessed the relationship between neck US findings and DDH occurrence, and investigated the clinical features of CMT related to DDH.
Results: 18 patients (14.9%) were diagnosed as having DDH by US. However, most DDH was subclinical and spontaneously resolved. Only 2 patients (1.7%) needed to be treated with a harness. Th e positive predictive value of clinical examinations for DDH was 52.6% and patients treated by harness were all clinically positive. DDH was more common in the left side (13 left, 4 right, 1 both), but 6 out of 18 DDH (33.3%) cases presented on the contralateral side of CMT. Sex diff erence was not observed. Breech presentation and oligohydramnios were not related to DDH occurrence. Neck US fi ndings did not correlate with DDH occurrence.
Conclusion: The coexistence rate of CMT and DDH was concluded to be 14.9%. If only DDH cases that required treatment were included, the coexistence rate of these two disorders would be lowered to 1.7%. All of these patients showed positive findings in clinical examination. Therefore, hip US should not be recommended routinely for patients with CMT.
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KEYWORD
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Congenital muscular torticollis, Developmental dysplasia of the hip, Ultrasonography
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