Which finding is a better indicator of developmental dysplasia of the hip (DDH) in infants?

Which finding is a better indicator of developmental dysplasia of the hip (DDH) in infants?

• A. Galeazzi and Klisic tests with limited abduction and apparent thigh-length discrepancy
• B. Normal hip exam
• C. Positive Ortolani only
• D. Family history of DDH

Answer: (A)

Detecting DDH in infants is most dependable when multiple clinical signs point to hip misalignment. The Galeazzi (Allis) sign shows a leg-length discrepancy when the hips and knees are flexed, so the affected leg appears shorter. The Klisic sign checks the location of the greater trochanter; a malposition indicates the femoral head is not where it should be in the acetabulum. When these signs occur together with limited hip abduction and an apparent thigh-length discrepancy, the suspicion for DDH is strong because you’re seeing both structural misalignment and its functional effect on movement. A normal hip exam does not rule out DDH in every infant, especially early on. A positive Ortolani test alone indicates a reducible dislocation but can be missed in some hips or may not reflect the broader instability. Family history increases risk but is not a definitive diagnostic finding by itself.

Detecting DDH in infants is most dependable when multiple clinical signs point to hip misalignment. The Galeazzi (Allis) sign shows a leg-length discrepancy when the hips and knees are flexed, so the affected leg appears shorter. The Klisic sign checks the location of the greater trochanter; a malposition indicates the femoral head is not where it should be in the acetabulum. When these signs occur together with limited hip abduction and an apparent thigh-length discrepancy, the suspicion for DDH is strong because you’re seeing both structural misalignment and its functional effect on movement.

A normal hip exam does not rule out DDH in every infant, especially early on. A positive Ortolani test alone indicates a reducible dislocation but can be missed in some hips or may not reflect the broader instability. Family history increases risk but is not a definitive diagnostic finding by itself.