Case history
Case history
A baby girl is seen for a routine exam at 2 weeks of age. She was born at term with no pregnancy or delivery complications. A screening exam of the hips, using the provocative tests of Barlow and Ortolani, reveals laxity of the left hip joint. A characteristic "clunk" is felt as the femoral head shifts out of the acetabulum with direct pressure applied posteriorly in the adducted hip, as well as when it shifts back into the acetabulum with the hip abducted and anterior pressure applied.
Other presentations
Developmental dysplasia of the hip (DDH) is typically identified through a screening exam of the hips of infants. However, DDH may sometimes come to medical attention after the parents notice one or more of the following: one leg appearing shorter than the other, one hip joint moving differently from the other and/or the knee appears to face outwards, one leg does not appear to move outwards as fully as the other (e.g., with diaper changes), or the child crawls with one leg dragging. The value of assessing leg-length discrepancy and skinfolds in identifying DDH is not supported by available evidence.[1] Some cases of DDH may present beyond the first year of life, typically with pain or abnormal gait as the presenting symptoms. Parents may notice "toe-walking," especially on one side, which may indicate a potential shortening on the affected side, or that the child walks with a limp.
Use of this content is subject to our disclaimer