ORIGINAL ARTICLE A radiographic clinic for developmental dysplasia of the hip (DDH) Gerard A. Sheridan 1,2 & Matthew Nagle 1 & Catherine Howells 1 & Olga Gallagher 1 & Patrick J. Kiely 1 & Patrick O’Toole 1 & Paula M. Kelly 1 & David P. Moore 1 Received: 30 April 2019 /Accepted: 13 May 2019 # Royal Academy of Medicine in Ireland 2019 Abstract Background We describe the first radiographic clinic in the literature for DDH and how this novel clinic can significantly improve the efficiency and cost-effectiveness of service in a tertiary referral centre. Aims A radiographic clinic for the management of developmental dysplasia of the hip was introduced in 2017 in our institution. We performed a detailed cost analysis to assess the economic savings made with the introduction of this new clinic. We assessed the efficiency of the service by identifying how many unnecessary outpatient visits were prevented. We also assessed the difference in times from referral to review between the two clinics. Methods Analysis of the clinic activity in 2017 was possible as all data was collected prospectively by the DDH CNS and stored in our database. Cost analysis was performed, and the savings made per patient along with the financial benefit to our institution was recorded. Results The new radiographic clinic reduced the cost of reviewing one patient by €162.51 per patient. There was a 73% discharge rate from the clinic which prevented 251 unnecessary patient visits to the outpatient department over the course of the year. There was a significant 11-day reduction in waiting times between referral and review when comparing the radiographic to the conventional clinic (p < 0.05). Conclusions A radiographic clinic for the management of developmental dysplasia of the hip has a significant effect on the efficiency and overall cost-effectiveness of service provision in a tertiary referral centre. Keywords Cost-effective . Orthopaedic . Paediatric . Virtual clinic Background Developmental dysplasia of the hip (DDH) is a condition re- quiring early diagnosis and management to optimise long- term outcomes. Nationally, we experience a higher incidence of late diagnoses and open surgery despite a normal incidence of DDH when compared with international figures [1]. In an effort to meet the national demand imposed by this condition, we describe the implementation of the first radiographic clinic for developmental dysplasia of the hip (DDH) in a tertiary referral national paediatric centre. A radiographic clinic for this condition has not been described in the literature to date. We prospectively analyse the clinic’ s introduction from a number of perspectives: 1. Improved service provision. 2. Economic savings. 3. Patient safety. 4. Societal gains. Methods Referral process The radiographic DDH clinic was implemented in our institu- tion on January 1, 2017. This concept stemmed from an ob- servation made in our pre-existing ‘rapid access hip clinic’. This rapid access clinic was initially established to address long waiting times experienced by DDH patients. We noted that many patients were initially being referred to our * Gerard A. Sheridan sheridga@tcd.ie 1 Department of Orthopaedics, Our Lady’ s Children’ s Hospital Crumlin, Dublin, Ireland 2 Deerpark, Lobinstown, Navan, Co. Meath, Ireland Irish Journal of Medical Science (1971 -) https://doi.org/10.1007/s11845-019-02039-y