Developmental Dysplasia Of The Hip Flashcards
What is developmental dysplasia of the hip (DDH)?
It is defined as a congenital condition in which there is abnormal development of the hip joint
This results in dysplasia and subluxation of the hip
Which hip tends to be affected by developmental dysplasia of the hip?
Left hip
What eight risk factors are associated with developmental dysplasia of the hip?
Female Gender
Family History
Firstborn Child
Breech Presentation
Oligohydramnios
Birth Weight > 5kg
Fixed Foot Deformity
Torticollis
What are the six clinical features of developmental dysplasia of the hip?
Hip Pain
Hip Locking
Leg Length Discrepancy
Reduced Hip Abduction
Asymmetrical Buttock Creases
Trendelenburg Gait
What are the three investigations used to diagnose developmental dysplasia of the hip?
Clinical Examination
Ultrasound Scan
Hip X-Rays
What two clinical examination tests are used to diagnose developmental dysplasia of the hip?
Barlow’s Test
Ortolani’s Test
How is the Barlow’s test conducted?
It involves abduction of the hip, whilst there is application of light pressure on the knee, with the examiner’s thumb directing force posteriorly
This manoeuvre attempts to dislocate the newborns femoral head
What Barlow’s test result indicates developmental dysplasia of the hip?
A palpable sensation of subluxation, as the femoral head slips over the posterior rim of the acetabulum
How is Ortalani’s test conducted?
It involves flexion of the hip and knees of a supine infant to 90 degrees, with the examiners index fingers placing anterior pressure on the greater trochanters, gently and smoothly abducting the infant’s legs using thumbs
This manoeuvre attempts to relocate the newborns femoral head
What Ortolani’s test result indicates developmental dysplasia of the hip?
A distinctive clunk which can be heard and felt as the femoral head relocates anteriorly into the acetabulum
When are ultrasound scans used to diagnose developmental dysplasia of the hip?
They are the first line investigation conducted in infants less than 4.5 months old
What is the feature of developmental dysplasia of the hip on ultrasound scan?
Increased angle between the acetabulum and ileum
When are hip x-rays used to diagnose developmental dysplasia of the hip?
They are the first line investigation conducted in infants older than 4.5 months old
What is the feature of developemental dysplasia of the hip on hip x-rays?
Asymmetry of the femoral head ossification centre
What screening programme of developmental dysplasia of the hip?
It is screened for in all infants at both the newborn check and six-week baby check through clinical examination
However, in cases where individuals have risk factors (first-degree family history of congenital hip problems, breech presentation > 36 weeks, multiple pregnancy), then a routine ultrasound scan should be conducted at 6 weeks
