Developmental Dysplasia of the Hip (DDH): The Daily PANCE Blueprint
Which of the following is the most important risk factor for developmental dysplasia of the hip?
A. Premature birth
B. Male sex
C. Family history
D. Firstborn child status
E. Maternal diabetes
Answer and topic summary
The answer is C. Family history.
Developmental dysplasia of the hip (DDH) is defined by subluxation/dislocation of the femoral head, acetabular dysplasia, or hip instability. The top two risk factors are (1) family history and (2) breech presentation. Clinical features depend on the age of the patient, but you may see a positive Ortolani or Barlow sign, unequal thigh folds, inability to abduct the hip, prominent Galeazzi sign, hip pain, and leg length discrepancy. Hip ultrasound is the imaging of the choice when <4 months, and a pelvic x-ray is preferred when >4 months. Treatment is a Pavlik harness; if the patient fails that or is already at an older age, then they will need closed reduction or possibly open reduction (+/- pelvic/femoral osteotomy).
Barlow sign: palpable clunk when the hip is flexed and ADducted (while applying downward pressure)
Ortolani sign: palpable clunk when the hip is flexed and ABducted (while applying upward pressure)
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Covered under ⇒ PANCE Blueprint Musculoskeletal ⇒ ⇒
