Summary
Definition
History and exam
Key diagnostic factors
- positive Ortolani test
- positive Barlow test
- limited hip abduction
Other diagnostic factors
- abnormal positioning of the leg or delayed crawling/walking
- toe-walking (especially unilateral)
Risk factors
- female sex
- positive family history
- breech presentation
- postural deformity
- restricted intrauterine space
- incorrect lower-extremity swaddling
Diagnostic investigations
1st investigations to order
- ultrasound of hips
- hip x-ray
Treatment algorithm
<6 months of age
6-18 months of age
>18 months to 6 years of age
>6 years of age
Contributors
Authors
Kathleen Moen, MD
Pediatric Specialty Care
Swedish Medical Group
Seattle
WA
Disclosures
KM declares that she has no competing interests.
Acknowledgements
Dr Kathleen Moen would like to gratefully acknowledge Dr Scott Shipman, a previous contributor to this topic. SS is an author of a reference cited in this topic.
Peer reviewers
Andreas Roposch, MD, MSc, FRCS
Consultant Orthopaedic Surgeon
Reader in Clinical Epidemiology and Surgery
UCL Institute of Child Health and Great Ormond Street Hospital for Children NHS Trust
London
UK
Disclosures
AR declares that he has no competing interests.
Nicholas M. Clarke, ChM, FRCS
Professor
Consultant Orthopaedic Surgeon
Developmental Origins of Health and Disease (DOHaD)
School of Medicine
University of Southampton
Southampton
UK
Disclosures
NMC has received honoraria for visiting professorships in North America and also for lectures in respect of congenital hip dysplasia. He is also a founding member of the International Hip Dysplasia Institute, which has received charitable funding.
Blaise Nemeth, MD
Assistant Professor (CHS)
Departments of Orthopedics and Pediatrics
University of Wisconsin School of Medicine and Public Health
Madison
WI
Disclosures
BN declares that he has no competing interests.
Differentials
- Acetabular immaturity
- Proximal femoral focal deficiency
- Residual effects of septic arthritis
More DifferentialsGuidelines
- Evidence-based clinical practice guideline: detection and nonoperative management of pediatric developmental dysplasia of the hip in infants up to six months of age
- ACR Appropriateness Criteria: developmental dysplasia of the hip - child
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