The Role of Childhood Screening Tests in Pediatric Orthopedics

Childhood screening exams —particularly screenings in the field of orthopedics—play a crucial role in ensuring the healthy musculoskeletal development of children. Many musculoskeletal disorders are initially asymptomatic and only manifest later, sometimes in the form of irreversible problems. Regular and professional screening is key to early detection and timely treatment.

One of the most important tasks in pediatric orthopedics is preventive screening. Pediatric orthopedic screening begins in infancy and continues until adulthood (age 18). The goal of these screenings is to identify, before symptoms develop, any abnormalities that could cause pain, limited mobility, or developmental delays in the future.

Age-specific screenings are associated with specific stages of a child’s development. During these screenings, an orthopedic specialist assesses the condition of the musculoskeletal system and, if necessary, recommends intervention options.

The Importance of Infant Hip Screening

The first and one of the most critical childhood screening tests is the infant hip screening, which is recommended to be performed before the age of 6 weeks. During the examination, an ultrasound examination and a physical examination are used to detect any potential developmental abnormalities.

What is a “silent hip”?

The term “silent hip” refers to hip joint abnormalities that, although asymptomatic, can lead to serious musculoskeletal problems if left untreated. Examples include congenital hip dislocation or an early form of hip joint instability. Screening allows for the early detection of these conditions, and with appropriate treatment, a full recovery is even possible.

How is a newborn’s hip screening performed?

The purpose of infant hip screening is to detect developmental abnormalities of the hip joint at an early stage, with a particular focus on preventing congenital hip dislocation. The examination is painless, quick, and completely safe for the baby.

A step-by-step guide to hip screening:

1. Recording the medical history

The examination begins with a brief conversation. The specialist asks :

• the circumstances of pregnancy and childbirth,
• the baby’s birth weight,
• breech presentation or twin pregnancy,
• orthopedic problems that run in the family.

2. Physical Examination

Next comes the manual (by hand) examination of the baby’s hip joints :

• The baby is lying on his or her back, and the examiner gently moves the thighs in different directions.
• Checks the range of motion and flexibility of the hips, as well as any clicking or tightness.
• He observes the symmetry of the thigh creases, the difference in leg length, and the position of the legs.

3. Ultrasound examination

The next step is a hip joint ultrasound, which will help:

• we get an accurate picture of the structure and maturity of the hip joint,
• it can be determined whether the femoral head is properly positioned in the acetabulum,
• Early abnormalities (e.g., immaturity, instability, dislocation) can also be detected.

What happens if there is a discrepancy?

Most cases of mild hip dysplasia do not require treatment, only observation and follow-up examinations. In cases of more severe abnormalities, early treatment can lead to a full recovery—the sooner treatment begins, the better the results.

Monitoring Motor Development and Muscle Tone Disorders

After the hip screening, the focus shifts to monitoring motor development. During childhood screenings, specialists pay particular attention to changes in muscle tone and movement patterns. During the first year of life, many signs may indicate an abnormality that does not initially appear to be a problem.

What signs should you look for?

• If the child does not start rolling over, crawling, standing up, or walking on time.
• If its movement is asymmetrical—for example, if it turns only to one side.
• If your muscle tone is too tight or too loose.

In these cases, a specialist evaluation may reveal a need for targeted physiotherapy or other rehabilitative therapies.

The Role of Parents

The active participation of parents is essential to the effectiveness of pediatric orthopedic screenings. Timely completion of regular examinations and careful monitoring of motor development contribute significantly to the prevention of abnormalities.

An experienced specialist can help

Childhood screening exams —especially screenings in the field of orthopedics—are essential for a child’s healthy motor development. Early detection, targeted intervention, and parental cooperation make it possible to prevent future musculoskeletal problems and ensure harmonious development.