Fantoms
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Sharpe et al describe the epidemiology of late presenting developmental dysplasia of the hip (DDH) in South Australia. Of 1281 cases of DDH identified in the context of a screening programme based on repeated clinical examinations 27 cases were first identified late (after 3 months of age). Earlier work by the same group indicated that around 40% of all cases that ultimately required surgery presented late. The late presenting cases were often identified by family members rather than clinicians. Only one of the 27 who presented late was born in the breech position. Normal delivery, rural birth and early discharge from hospital were associated with higher risk of late presentation. It is unclear whether the risk factors for late presentation are truly different from those in cases diagnosed early or whether a greater success in identifying DDH in infants with traditionally recognised risk factors has skewed the characteristics of the
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