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6 Cards in this Set

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What radiologic techniques are most suitable to screen for developmental hip dysplasia?
At what ages?
Before 6 mos: u/s (with normal exam, can delay to 4-6 weeks old)
After 6 mos: AP radiograph
Name 8 clinical conditions associated with markedly increased risk of developmental hip dysplasia, where screening should be advised despite normal PE.
1) Torticollis (8-20%)
2) Clubfoot or calcanovalgus feet (25%)
3) Metatarsus adductus (10%)
4) Down syndrome
5) Congenital knee dislocation
6) Arthrogryposis
7) Myelomeningocele
8) Larson's syndrome
Name 5 clinical presentations of hip dysplasia in an infant over 2 mos old.
1) Asymetric shortening on the affected side (Galeazzi sign)
2) Leg on affected side may turn outward
3) Tight hip abductors/decreased hip abduction
4) Asymmetric thigh or gluteal folds
5) Space between legs may look wider than usual
Name 2 clinical presentations of hip dysplasia in the walking child.
Pain is not common in kids!
1) Mild hip flexion contractures (bilateral) may produce lumbar hyperlordosis and a waddling gait.
2) Unilateral dislocation may produce a short leg gait or limp
Ortelani Test:
1) Where do examiner's digits go (2 points to recall)
2) What is the motion?
3) What is sought?
1) Thumbs on the medial thigh, fingers place gentle upward stress on lateral thigh and greater trochanter area.
2) Apply slow abduction while fingers continue gentle upward stress
3) A dislocated and reducable hip will reduce with a palpable "clunk."
Barlow Maneuver
1) How is it done? (2 steps)
2) What is sought?
1) Procedure
a) Guide hips into mild adduction
b) Slight forward pressure with thumb
2) The unstable femoral head will slip over the posterior edge of the acetabulum producing a palpable "clunk."