©1994 British Editorial Society of Bone and Joint Surgery 0301-620X/94/4837 $2.00 534 THE JOURNAL OF BONE AND JOINT SURGERY ROUTINE ULTRASOUND SCREENING FOR NEONATAL HIP INSTABILITY CAN IT ABOLISH LATE-PRESENTING CONGENITAL DISLOCATION OF THE HIP?

We have undertaken routine ultrasound screening for neonatal hip instability in Coventry since June 1989. Of the 14 050 babies scanned during the first three years, 847 (6%) had ultrasound abnormalities. A grading system, based on the percentage of femoral head coverage, is presented. The proportion of abnor-mal hips decreased gradually so that by nine weeks, 90 % had normal ultrasound appearances. Abnormal-ity was more common in babies with a family history of CDH and in breech presentations. All babies with clinically abnormal hips had an abnormal first ultra-sound examination. Five babies not diagnosed by clinical examination and with no risk factors had abnormal ultrasound appearances and were subsequently found to have clinically abnormal hips. Routine ultrasound screening has detected cases which would otherwise have presented late