Pediatric hip dysplasia and evaluation with ultrasound

Developmental dysplasia of the hip is a frequent condition in newborns. Certain risk factors have been associated with this condition, including female sex, a family history, a breech presentation and certain ethnicities; however, most cases of dysplasia occur in girls without any other risk factors. Clinical examination using the Barlow/Ortolani tests in newborns or by the finding of limited abduction in slightly older children may reveal the diagnosis, but childen with an inconclusive examination or with a risk factor should be referred for further screening. Ultrasonography can detect dysplasia that may not be evident on physical exam or plain radiographs. When dysplasia is identified, treatment should be instituted, and in young children dynamic splinting with the Pavlik harness is safe and effective. Early detection and treatment provides the best long-term results.