CONGENITAL DISLOCATED HIP

Question 1

dislocation occurs in what directions?

Answer 1

lateral, posterior, and superior direction

Question 2

CDH must be differentiated from?

Answer 2

dislocation
dislocatable
subluxable
dysplastic

Question 3

what is this?

femoral head is in the acetabulum but it can be displaced out of the acetabulum

Answer 3

dislocatable

Question 4

what it this?

subluxable, partial dislocation of the hip but can’t get full dislocation

Answer 4

subluxable

Question 5

what is this?

components of the hip have formed abnormally are deformed, abnormality of development, alteration in size, shape and organization of adult cells

Answer 5

dysplastic

Question 6

incidence of dislocatable hip?

*incidence of dislocated hip?

Answer 6

12:1000 live births

60% improve during the first week of life

*1:1000, incidence in females 8 times that in males and in premature child

Question 7

what is this?

acetabulum is shallow or otherwise deformed

anterior displaced of the acetabulum on the pelvis

abnormality in size or character of the acetabulum

*remember it is not external rotation of the acetabulum

Answer 7

acetabular dysplasia

Question 8

in neonates this is a large nutrient artery and not a ligament, function is not like a ligament at all,

what is this?

Answer 8

ligament capitus femoris

Question 9

etiology of CDH?

Answer 9

30% of children born in breech presentation, extension of hip and traction at delivery

Question 10

the change of one parent who has had CHD having a child with CDH is what parcent?

Answer 10

36%, heredity in CDH

Question 11

what is the incidence of CDH bilaterally? greater in left or right?

Answer 11

25%

left hip greater than right hip

Question 12

clinical presentation of CHD?***

Answer 12

limitation of abduction with thigh flexed*
unequal hip total range of motion*
limp-child exhibits antalgic gait
shortening of limb on affected side*
telescoping sign
skin folds noted-posteriorly

Question 13

abduction of 50 degrees or less at hip joint is an indication of _____?

Answer 13

CDH

Question 14

necrosis of the head of the femur is noted in this disease and in differentiation of CDH?

Answer 14

leg perthes

Question 15

common workup for CDH?

Answer 15

radiographs
CBC
ESR

*not rheumatoid factor

Question 16

in the examination of neonatal hip, what is the test based on the following?

knees bent, hip flexed to 90 degrees abduction
clunk sound is relocation of the femoral head over the posterior rim of the acetabulum
palpable fell of reloation
no audible click necessary

Answer 16

ortalani sign

Question 17

in the examination of the neonatal hip, what is this test based on the following?

infant on their back
hips and knees flexed
thumb pressure applied anterior to posterior direction over lesser trochanter
dislocate femoral head posteriorly, not painful if pt has dilocated hip

Answer 17

Barlows sign

Question 18

in the examination of neonatal hip, what test is used on a child greater than 6 months based on the following?

unilateral test
child placed on back
flex leg against thigh
knee affected side appears lower

Answer 18

galezzi test/allis test

Question 19

femoral head is normally below or above the hilgreiners line?

Answer 19

below

Question 20

a vertical line from the lateral margin of the ossified acetabular roof that is normally tangential to the lateral margin of the ossification center of the femoral head and perpendicular to hilgreiners line?

a horizontal line through the triradiate cartilage of the acetabulum?

Answer 20

Perkins line

hilgenreiners line