• Marcio Luís Duarte, Giovanna Galvão Braga Motta, Natasha Vogel Majewski Rodrigues, Alessandra Rodrigues Silva Chiovatto, Eduardo Davino Chiovatto, and Wagner Iared.
• MD, MSc. Musculoskeletal Radiologist, WEBIMAGEM Telerradiologia, São Paulo (SP), Brazil. Doctoral student in Evidence-based Health Program, Universidade Federal de São Paulo (UNIFESP), São Paulo (SP), Brazil.
• Sao Paulo Med J. 2022 Jan 1; 141 (2): 154167154-167.

BackgroundDevelopmental dysplasia of the hip (DDH) encompasses a broad spectrum of hip pathologies, including femoral or acetabular dysplasia, hip instability, or both. According to the medical literature, ultrasonography is the most reliable diagnostic method for DDH. Several techniques for the assessment of hips in newborns and infants, using ultrasonography, have been described.ObjectiveTo compare the accuracy of the Graf technique and other diagnostic techniques for DDH.Design And SettingA systematic review of studies that analyzed ultrasound techniques for the diagnosis of DDH within an evidence-based health program of a federal university in São Paulo (SP), Brazil.MethodsA systematic search of relevant literature was conducted in the PubMed, EMBASE, Cochrane Library, CINAHL, and LILACS databases for articles published up to May 5, 2020, relating to studies evaluating the diagnostic accuracy of different ultrasound techniques for diagnosing DDH. The QUADAS 2 tool was used for methodological quality evaluation.ResultsAll hips were analyzed using the Graf method as a reference standard. The Morin technique had the highest rate of sensitivity, at 81.12-89.47%. The Suzuki and Stress tests showed 100% specificity. The Harcke technique showed a sensibility of 18.21% and specificity of 99.32%.ConclusionAll the techniques demonstrated at least one rate (sensibility and specificity) lower than 90.00% when compared to the Graf method. The Morin technique, as evaluated in this systematic review, is recommended after the Graf method because it has the highest sensitivity, especially with the three-pattern classification of 89.47%.Registration NumberIdentifier: CRD42020189686 at the International Prospective Register of Systematic Reviews (identifier: CRD42020189686).

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