A new study has found NHS infant checks can often miss serious hip abnormalities in new-born babies, which, if left undetected, can require complex surgery.
The research conducted by the Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford and University of Leeds found issues with tests currently used by healthcare professionals.
Using data from 27,000 babies, researchers discovered the best tests available still miss more than half of abnormal hips.
On average, for every 1,000 hips screened, four dislocations are identified, but five are missed.
Developmental dysplasia of the hip (DDH), a condition where the ball and socket joint of the hip does not properly form in babies and young children, is among the most common musculoskeletal conditions in infants.
About one in every 100 babies are born with the ball of the hip bone dislocated from the socket.
When diagnosed early, a dislocated hip can usually be treated with a removable brace that the baby wears for a couple of months.
But a delayed diagnosis often leads to complex surgery and could cause early arthritis, potentially leading to a hip replacement in young adulthood.
The NHS baby hip screening checks are carried out within 72 hours of birth and again between six to eight weeks.
However, researchers highlighted previous doubts concerning the reliability of these tests.
Dr Abhinav Singh, orthopaedic surgeon and researcher at the University of Oxford, said: "It is important that doctors are well trained in the hip examination and know which tests can help identify hip abnormalities.
"However, our findings clearly highlight that examining babies’ hips will not identify all dislocations.
"Emphasising certain examination manoeuvres that can assist in early diagnosis of DDH is of clear benefit to infants, their families and the clinician, but our results also provide evidence of the fallibility of the examination."
Professor Daniel Perry, National Institute for Health and Care Research professor at the University of Liverpool and a children’s orthopaedic surgeon at Alder Hey Children’s Hospital said: "Doctors have known for some time that there are challenges with the new-born hip examination and this study confirms the problem.
"What brings additional concern is that all hip examinations in this study were conducted by experts in hip disease – which is not usually the case in the NHS – so the true problem may be bigger.
"NHS England has recently started working with the National Institute for Health and Care Research to begin research to improve hip screening amongst babies.
"We hope that this could soon mean new tests on the hips of babies, such as artificial intelligence enabled ultrasound. "
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