[Initial results from an ultrasound screening program for the detection of developmental dysplasia of the hip in girls]. / Résultats initiaux d'une expérience de dépistage échographique systématique de la luxation congénitale de hanche chez la fille.

PURPOSE: To determine the value of US screening for detection of developmental dysplasia (DDH) in girls in the setting of a multi-disciplinary program in pediatric orthopedics. MATERIALS AND METHODS: Systematic US evaluation of the hips using the Couture technique was performed at 1 month in all girls with normal physical examination at birth over a 1 year period. The examinations were classified as normal or abnormal (DDH [acetabular depth> 6], asymmetrical pelvis, borderline hips). Results were correlated with risk factors and clinical outcome. Girls with abnormal hips were immediately treated. RESULTS: One thousand one hundred and sixty-six girls were screened. A total of 4.7% of ultrasound examinations were abnormal. The rate of pathological hip was 3.7% in the absence of risk factors and 8.9% in the presence of risk factors. A total of 63.6% of girls with abnormal ultrasound examination had no risk factor. Two risk factors were correlated to the presence of DDH: family history (RR=3.12) and clinical abnormalities (RR=2.55). The rate of pathological hip that were referred for treatment was 3.1%. All hips were normal at 5 months. CONCLUSION: Ultrasound screening evaluation of the hip in girls at 1 month, in the setting of a multi-disciplinary program in pediatric orthepedics clinic, is feasible. A total of 74 abnormal hips undetected at the initial clinical evaluation in girls without risk factor were detected and treated. Systematic screening of girls for DDH must be further assessed to better determine its impact on the incidence of delayed diagnosis of DDH.

Association of systemic lupus erythematosus and choriocarcinoma: a role of hormonal immunomodulation?

We report the first case of choriocarcinoma occurring during the course of systemic lupus erythematosus (SLE). This choriocarcinoma was revealed by pulmonary metastasis associated with pulmonary hypertension secondary to neoplastic thrombi and pulmonary embolism, in parallel to a flare up of the SLE. The role of hormones in SLE is discussed.