Developmental dysplasia of the hip

Last reviewed: 2 Jun 2022
Last updated: 08 Jan 2020

Summary

Definition

History and exam

Key diagnostic factors

  • positive Ortolani test
  • positive Barlow test
  • limited hip abduction
More key diagnostic factors

Other diagnostic factors

  • abnormal positioning of the leg or delayed crawling/walking
  • toe-walking (especially unilateral)
Other diagnostic factors

Risk factors

  • female sex
  • positive family history
  • breech presentation
  • postural deformity
  • restricted intrauterine space
  • incorrect lower-extremity swaddling
More risk factors

Diagnostic investigations

1st investigations to order

  • ultrasound of hips
  • hip x-ray
More 1st investigations to order

Treatment algorithm

ONGOING

<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 Differentials
  • Guidelines

    • AIUM–ACR–SPR–SRU practice parameter for the performance of an ultrasound examination for detection and assessment of developmental dysplasia of the hip
    • ACR Appropriateness Criteria: developmental dysplasia of the hip - child
    More Guidelines
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