Highlights & Basics
- Developmental dysplasia of the hip (DDH) represents a spectrum of conditions affecting the proximal femur and acetabulum, ranging from acetabular immaturity to hip subluxation and frank hip dislocation.
- The Barlow and Ortolani screening tests are recommended up to 6 months of age, although they begin to lose their sensitivity and usefulness around 3-6 months of age due to increased musculature. Thereafter, limited and/or asymmetric hip abduction suggests the diagnosis.
- Ultrasound may be used to confirm an abnormal hip exam, but should be used with caution as a preliminary screening test due to the high number of false positive results.
- There is a high rate of spontaneous resolution of hips identified as mildly abnormal by both clinical exam and ultrasound in the neonatal period. Frank dislocations and persistently abnormal exams should be referred to a pediatric orthopedist.
- Most cases can be treated nonsurgically using an abduction harness (Pavlik harness). If a harness fails, a rigid abduction brace may be used.
Quick Reference
History & Exam
Key Factors
Other Factors
Diagnostics Tests
Treatment Options
Definition
Epidemiology
Etiology
Pathophysiology
Citations
Shipman SA, Helfand M, Moyer VA, et al. Screening for developmental dysplasia of the hip: a systematic literature review for the US Preventive Services Task Force. Pediatrics. 2006;117:e557-e576.[Abstract]
American Academy of Orthopaedic Surgeons. Detection and nonoperative management of pediatric developmental dysplasia of the hip in infants up to six months of age. Mar 2022 [internet publication]. [Full Text]
Shaw BA, Segal LS. Evaluation and referral for developmental dysplasia of the hip in infants. Pediatrics. 2016 Dec;138(6).pii:e20163107.[Abstract][Full Text]
American College of Radiology. ACR Appropriateness Criteria: developmental dysplasia of the hip -- child. 2018 [internet publication].[Full Text]
Julie S, Quinn RH, Murray J, et al. Management of developmental dysplasia of the hip in infants up to six months of age: intended for use by general pediatricians and referring physicians. J Am Acad Orthop Surg. 2019 Apr 15;27(8):e356-9.[Abstract][Full Text]
Samora J, Quinn RH, Murray J, et al. Management of developmental dysplasia of the hip in infants up to six months of age: intended for use by orthopaedic specialists. J Am Acad Orthop Surg. 2019 Apr 15;27(8):e360-3.[Abstract][Full Text]
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