University of Oklahoma Health Sciences Center

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Date Added:

April 23, 2024

Journal/Publication:

JN Learning

Publisher:

JAMA Network

Publication Date:

April 15, 2024

URL:

Examining for a Dislocated Hip in Infants

Type:

Meta-analyses, Reviews, and Guidelines

Format:

Video

Keywords

newborns

hips

Examination

dislocated hip

MeSH

RPR Commentary

For those of you who still see newborns, this video is refresher on how to examine their hips. James W. Mold, MD, MPH

Abstract

In many countries clinical examination is the primary screening tool to identify dislocated hips in newborns, with a positive screening examination typically triggering an ultrasound assessment of the hips. However, the condition is rare and the examination can be difficult to perform. We explore the key components of the examination - symmetry of limb length, symmetry of abduction and consider the ’special tests’ of instability, known as the ‘Barlow’ and ‘Ortolani’ maneuvre. However, given the rarity of the disease, even in expert hands for every 1000 newborn hips screened with the clinical examination, relying on the Barlow and Ortolani maneuvres will identify 5 dislocations, result in 13 “unnecessary” ultrasound scans and 4 missed diagnoses. For every 1000 newborn hips screened with limited hip abduction, the system would identify 1 dislocation, result in 33 “unnecessary” ultrasound scans and 8 missed diagnoses per 1000 newborn hips.