Virtual Pediatric Hospital(tm) : A digital library of pediatric information

Home | Search | About Us | FAQ | Reviews | Contact Us
Additional pediatric resources: SearchingPediatrics.com | Pediatric Commons Facebook iconTwitter iconRSS icon | PediatricEducation.org | GeneralPediatrics.com

Virtual Pediatric Hospital: Paediapaedia: Congenital Hip Dislocation (Infantile Hip Dislocation) (Congenital Dislocation of the Hip) (CD) (Developmental Dysplasia of the Hip) (DDH) Paediapaedia: Musculoskeletal Diseases

Congenital Hip Dislocation (Infantile Hip Dislocation) (Congenital Dislocation of the Hip) (CD) (Developmental Dysplasia of the Hip) (DDH)

Michael P. D'Alessandro, M.D.
Peer Review Status: Internally Peer Reviewed


Clinical Presentation:
In the neonate the diagnosis may be made clinically because the femoral heads are not ossified yet. The Ortolani/Barlow maneuver is used in which you attempt dislocation of the flexed hip by abduction of the proximal femur producing a click on posterior dislocation and another as the femoral head slides back into the acetabulum with adduction. Seen in 0.25-0.85% of newborns with a female to male predominance of 8:1. Most are unilateral and usually are on the left.

Etiology/Pathophysiology:
In utero dislocation of hip is unusual. Most dislocations occur after birth and are related to unstable or dislocatable hips. Major etiologic factors are ligamentous laxity of the joint capsule and intrauterine (breech) presentation. Acetabular dysplasia is a secondary sign of CDH and does not cause CDH. Ninety percent of dislocatable hips will stabilize in first 2 months of life if not treated, but the ones which will stabilize cannot be predicted so all patients are treated with a flexion-abduction-external rotation device.

Pathology:
Not applicable

Imaging Findings:
Ultrasound of the hips is very useful in making the diagnosis in the newborn.

Femoral head ossification centers appear at 3-6 months so radiographs are not useful in the newborn. By 2-4 months old you begin to see lateral displacement of the femur and an increased acetabular angle. In older children on pelvic films superolateral displacement of the proximal femur, increased acetabular angle, delay in appearance of capital femoral ossification center, loss of the lateral margin of acetabulum, abnormal sclerosis of acetabular rim, and formation of a false acetabulum are seen.

DDX:

References:
See References Chapter.

Section Top | Title Page


Additional pediatric resources: SearchingPediatrics.com | Pediatric Commons Facebook iconTwitter iconRSS icon | PediatricEducation.org | GeneralPediatrics.com
Home | Search | About Us | FAQ | Reviews | Contact Us

Virtual Pediatric Hospital is curated by Donna M. D'Alessandro, M.D. [Google+ Profile] and by Michael P. D'Alessandro, M.D.

Please send us comments by filling out our Comment Form.

All contents copyright 1992-2014 Donna M. D'Alessandro, M.D. and Michael P. D'Alessandro, M.D. and the authors. All rights reserved.

"Virtual Pediatric Hospital", the Virtual Pediatric Hospital logo, and "A digital library of pediatric information" are all Trademarks of Donna M. D'Alessandro, M.D. and Michael P. D'Alessandro, M.D.

Virtual Pediatric Hospital is funded in whole by Donna M. D'Alessandro, M.D. and Michael P. D'Alessandro, M.D. Advertising is not accepted.

Your personal information remains confidential and is not sold, leased, or given to any third party be they reliable or not.

The information contained in Virtual Pediatric Hospital is not a substitute for the medical care and advice of your physician. There may be variations in treatment that your physician may recommend based on individual facts and circumstances.

URL: http://www.virtualpediatrichospital.org/

This website is certified by Health On the Net Foundation. Click to verify. This site complies with the HONcode standard for trustworthy health information:
verify here.