Which tests are best used for a suspected developmental dysplasia of the hip (DDH) in an infant?

Which tests are best used for a suspected developmental dysplasia of the hip (DDH) in an infant?

• A. Gait analysis
• B. Ortolani and Barlow tests
• C. Bilateral hip x-ray
• D. Adam's forward bend test

Answer: (B)

The Ortolani and Barlow tests are specifically designed to assess for developmental dysplasia of the hip (DDH) in infants. These tests are performed during a physical examination to detect instability or dislocation of the hip joint. The Ortolani test aims to reduce a dislocated hip by abducting the hip while applying an upward force on the femur. A "clunk" may be heard or felt when the hip is relocated back into the acetabulum, indicating a positive test result and suggesting that the hip is dislocated. Conversely, the Barlow test checks for the ability to provoke a dislocation by flexing the hip and applying gentle adduction and posterior pressure. A positive Barlow test occurs when the hip is dislocatable, indicating an increased risk for DDH. In contrast, gait analysis is more appropriate for assessing older children or adults with hip dysfunction but does not provide the specific information needed for diagnosing DDH in infants. Bilateral hip x-ray can be useful in older infants for confirming a diagnosis, but it is not the first-line screening tool in young infants due to the prevalence of cartilaginous structures in early infancy, which may not be visible on x-ray. Lastly, Adam's forward bend

The Ortolani and Barlow tests are specifically designed to assess for developmental dysplasia of the hip (DDH) in infants. These tests are performed during a physical examination to detect instability or dislocation of the hip joint.

The Ortolani test aims to reduce a dislocated hip by abducting the hip while applying an upward force on the femur. A "clunk" may be heard or felt when the hip is relocated back into the acetabulum, indicating a positive test result and suggesting that the hip is dislocated. Conversely, the Barlow test checks for the ability to provoke a dislocation by flexing the hip and applying gentle adduction and posterior pressure. A positive Barlow test occurs when the hip is dislocatable, indicating an increased risk for DDH.

In contrast, gait analysis is more appropriate for assessing older children or adults with hip dysfunction but does not provide the specific information needed for diagnosing DDH in infants. Bilateral hip x-ray can be useful in older infants for confirming a diagnosis, but it is not the first-line screening tool in young infants due to the prevalence of cartilaginous structures in early infancy, which may not be visible on x-ray. Lastly, Adam's forward bend