A 4-month-old is suspected of having developmental dysplasia of the hip (DDH). What test would best assess for this?

A 4-month-old is suspected of having developmental dysplasia of the hip (DDH). What test would best assess for this?

• A. Barlow and Ortolani
• B. Galeazzi and Klisic
• C. Trendelenburg pelvic tilt test
• D. Romberg balance test

Answer: (B)

In a four-month-old, evaluating developmental dysplasia of the hip relies on maneuvers that reveal how the hip joint is seated and whether the femoral head sits properly in the acetabulum. The Galeazzi sign (Allis test) is useful here: with the baby lying on the back and the knees flexed, you compare the heights of the knees. If one knee sits higher, it suggests the femoral head on that side is not in the socket, indicating hip dislocation. The Klisic test complements this by tracing the position of the femoral head along the thigh as the hip is moved, helping detect displacement from the acetabulum. Together, these tests are more informative than newborn-specific maneuvers at this age. Barlow and Ortolani are best for identifying a dislocatable hip in the newborn period when joints are more lax, so they’re less reliable at four months. The Trendelenburg pelvic tilt test and Romberg balance test assess gait and balance in older children or adults, not hip stability in infants, so they don’t fit this scenario.

In a four-month-old, evaluating developmental dysplasia of the hip relies on maneuvers that reveal how the hip joint is seated and whether the femoral head sits properly in the acetabulum. The Galeazzi sign (Allis test) is useful here: with the baby lying on the back and the knees flexed, you compare the heights of the knees. If one knee sits higher, it suggests the femoral head on that side is not in the socket, indicating hip dislocation. The Klisic test complements this by tracing the position of the femoral head along the thigh as the hip is moved, helping detect displacement from the acetabulum. Together, these tests are more informative than newborn-specific maneuvers at this age.

Barlow and Ortolani are best for identifying a dislocatable hip in the newborn period when joints are more lax, so they’re less reliable at four months. The Trendelenburg pelvic tilt test and Romberg balance test assess gait and balance in older children or adults, not hip stability in infants, so they don’t fit this scenario.